Untitled1 [] · Jeffrey Perlman, Ph.D., I-CSW 5300 W. Atlantic Avenue Suite 503 Delray Beach, Fl...
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Untitled1 [] · Jeffrey Perlman, Ph.D., I-CSW 5300 W. Atlantic Avenue Suite 503 Delray Beach, Fl 33484 AUTHORIZATION FOR RELEASE OF INFORMATION (Insert Name of Patient/Client), whose
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