Christian Bringolf MA LMHC Forms
Please print off, review, sign and bring all the documents, with you to your first session.
If you have questions about these documents, please contact me and I'd be happy to answer them.
If you have questions about these documents, please contact me and I'd be happy to answer them.
| new_pt_intake_060419.pdf |
| disclosure_statement.pdf |
| new_credit_card_auth.pdf |
| fee_agreement.pdf |
| hipaa_npp.pdf |
Drayton Lemert MA LMHC Forms
| bc_authorization_form__1_.pdf |
| hipaa_d__1_.pdf |
| bc_drayton_lemert_ma_lmhc_disclosure_statement__2_.pdf |
| medical_purpose__1_.pdf |
| intake_form_ii.pdf |
| new_credit_card_auth__1_.pdf |
Geramy Hudson MA LMHC Forms
| authorization_to_treat[7726].pdf |
| disclosure_statement[7725].pdf |
| hipaa_npp[7727].pdf |
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