• Client Information Forms

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  • Family Data

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  • Medical History

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  • Employment

  • Additional Information


  • Symptom Checklist

    Adapted from the Hopkins Symptom Checklist-25 (HSCL-25)
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  • Health Insurance Information

    If the patient is uninsured or does not plan to use her or his insurance benefits to pay for psychotherapy services, we can provide a Good Faith Estimate of the range of expected costs. Just ask and we will be happy to provide it.
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