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SUSAN BEGLEY
Counselor

Individual Session Forms:
(You will need the following 3 forms)

HIPAA- Individual

Consent Form- Individual

Client Information

Couples Session Forms:
(You will need the following 4 forms)

Client Information (each adult)

Consent Form- Couples

Confidentiality Form- Couples

Child / Adolescent Session Forms:
(You will need the following 5 forms)

Client Information - Parent

HIPAA- Families

Client Information- Child

Confidentiality Form- Families

Consent Form- Child

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