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My PHI may be discussed with the following people I hereby agree to the above and consent for Perlman Clinic to obtain my past present and future medication and medical information as well as all other PHI Patient s Signature 9850 Genesee Avenue 320 La Jolla CA 92037 8am-5pm Mon-Fri 3900 5th Avenue 110 San Diego CA 92103 9am-6pm Mon-Thu 9am-4pm Sat 3737 Moraga Avenue B-103 4142 Adams Avenue 102 1905 Calle Barcelona 211 Carlsbad CA 92009 COMING SOON THIS WILL BE FILED WITH YOUR MEDICAL...
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