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Client Paperwork

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Client Agreement & Therapeutic Policies

*Required*

Consent for Services

*Required*

Limits of Liability

*Required*

Client Intake Form

*Required*

Release of Information

*Required*

​Please complete at least 2 of these - one for your insurance company and one for your emergency contact

Disclosure Limitation Addendum

Only to edit/limit release of information

Financial Agreement Addendum

Only for individuals paying out of pocket

Client Paperwork: Files

Contact

484.212.1766

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