Letter of Authorizzation

hereby authorize the He

ealth Authoritty of Abu Dhabi
D or Data
aFlow FZ LL
LC, its autho
orized affiliattes, agents
n
nd subsidiarie
es, acting on its behalf to verify information, docum
mentation and back ground
d verification presented
n my applicatiion form including but not limiting to edu
on ucation, emplo
oyment and liccenses.
 
 
 
th hority of Abu Dhabi or Data
he Health Auth aFlow FZ LLC
C, its authorizzed affiliates, a
agents and su
ubsidiaries.
 
 
Th
his informatio ontain but is not limited to
on / documentation may co o grades, dattes of attenda
ance, grade p
point average
e,
de
egree / diplom
ma certificatio
on, employme
ent title, emp
ployment tenu
ure, license a
attained, statu
us of the lice
ense, place of
o
issue and any
y other inform
mation deeme
ed necessary
y to conduct the verification of the information / d
documentation
n
prrovided.
 
 
I hereby releas
se all person
ns or entities requesting or supplying ssuch informattion from anyy liability arisiing from such
h
disclosure. I am willing thatt a photocopy
y of this auth
horization be accepted witth the same authority as the original. I
urther understtand and ack
fu knowledge tha
at this Inform
mation Releasse Form will remain valid for a period of two years
s
fo
ollowing its completion.
 
Peersonal Deta
ails:
(in
n BLOCK lette
ers)
 
Fu
ull Name :
(La
ast / Surname)) (Fi rst Name) (Middle Name)
 
 
Pa
assport / Identitty Card Numbe
er:
 
 
 
 
 
 
 
 
 
 
Signature Date (d
dd/mm/yyyy)