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"A healthy family is a sacred territory"
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~ Unknown Author
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Adult Intake Package - History, HIPPA, Consent for Treatment, Patient Payment Responsibility. Please bring completed forms to 1st appointment. |
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Child Intake Package - History, HIPPA, Consent for Treatment, Patient Payment Responsibility. Please bring completed forms to 1st appointment. |
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Consent For Treatment |
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Credit Card Payment Consent Form - If you need to make a distant payment, please download this form, complete and fax to (305) 936-1022. |
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| Make a payment with |
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| When you make your payment with |
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under 'Personal Note' please put patient's name and |
| any other descriptive information - thank you. |
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Group Consent Form |
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Information on Gifted Testing |
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Information on Psychological and Psychoeducational Testing - Includes the steps entailed, fees and list of tests used. |
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Informed Consent For Treatment Outside Office |
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Patient Information Release Form - Is needed in order to communicate with other professionals, physicians, teachers, etc. If you need us to communicate with someone, please download, complete form and fax to 305-936-1022. |
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Patient Payment Responsibility and Agreement |
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