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Release of Medical Information Request Authorization of
D. David S. Pearlman M. D. 125 Rampart Way. 80525 4700 E Bromley Ln. Suite 207 Brighton CO. 80601 2352 Meadows Blvd. Suite 300 Castle Rock CO. Suite 100 Denver CO. 80230 9331 S Colorado Blvd. Ste 100 Highlands Ranch CO. 80126 1667 Cole Blvd. Bldg. Leaders In Allergy Asthma Care For Over 40 Years Release of Medical Information Request Authorization of Protected Health Information PHI to CAAC I authorize the use/disclosure of health information about as described below Patient name and date...
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