Colorado PDMP

If you are an individual submitting a request on behalf of another individual who is the recipient of a controlled substance prescription, please complete the following form and remember to include:

• The original document establishing medical durable power of attorney of the individual submitting the request as power of attorney, or attorney for the individual who is the recipient of the controlled substance prescription, and
• Valid photographic identification of the individual submitting the request 

Confidential Patient Information Request for 3rd Party Representatives