Obtains patient information.
Informational sheet for the client’s use.
Provides consent to the therapist and Cornerstone Counseling Center to treat you.
Outlines how we may use your Protected Health Information (PHI).
Details many of Cornerstone Counseling Center’s policies about therapy.
Provides consent to Cornerstone Counseling Center to release information to outside parties such as insurance companies, physicians or referral sources. NO information about you or your treatment will be released without your consent.
If the client is under 14 years of age, please have a parent or guardian sign.
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