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Patient Forms and Policies

Patient Policies

Appointment Cancellation Policy
Credit Card on File Policy
Financial Procedures & Payment Policy
HIPAA Notice of Policies & Practices

Patient Forms

Authorization for Release of Information
Court Counseling Agreement
Parental Consent
Patient Agreement & Consent
Treatment Confidentiality & Custody Determination
Unable to Contact Parent or Guardian

For more information please call 610.544.2110