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Safe Harbours Therapy
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Forms
New Clients:
bring these completed forms to your first session.
Client Intake and Patient Agreement Form
Download
Biopsychosocial Intake
Download
Medication Form
Download
HIPPA Rights (for insurance users)
Download
Confidential Release of Information to your Doctor
Download
Collateral Agreement (for Couple's Therapy to be completed by person in couple not focus of treatment)
Download
ADHD Questionnaire Adult
Download
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About
What We Treat
Therapies
Forms
Contact Us
VISIT US
3434 Street Address
Beverly Hills, CA
T: 555-555-5555
E:
[email protected]