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Forms

Informed Consent of Treatment

Consent form detailing rights and responsibilities of the client and therapist.

Telehealth Informed Consent

Consent form detailing rights and responsibilities specific to Telehealth.

Fee Schedule

Form to disclose fees, payment and billing policies.

CONTACT US

Address: P.O. Box 171, Hicksville, OH 43526

Tel: 260-667-3807

You can also contact us by using this form:

Thank you for contacting us!

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