Forms
Please print and complete the forms for your specified practitioner.
Bring with you to your intake appointment.
Bring with you to your intake appointment.
Forms to Complete:
- The Intake Form for your specified age range
- Form of Identification
- Insurance card(s)
Katie Padron, LMSW
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Cristina Stauffer, LMSW
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DeWanda Gichemi, LMSW
| dewanda_-_adult_intake.docx.pdf |
| dewanda_-_adolescent_intake__ages_13-17_.docx.pdf |
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