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Anna Cross
M.Ed, L.P.C.
Helpful Forms

 

New Client Forms:

Adult Information Form

Child Information Form



First Appointment Checklist:

·      Information Form completed

·      Informed Consent and Privacy Notice reviewed and signed

·      If you are using your insurance benefits please bring your insurance card and a picture ID

 

 

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:


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