39755 Murrieta Hot Springs Rd, #D160 Murrieta, California 92563, United States
(951) 821-0557
(951) 821-0557
Home
About
Client Forms
Contact
More
Home
About
Client Forms
Contact
Home
About
Client Forms
Contact
Kimberly A Gaines Counseling
Kimberly A Gaines Counseling
Kimberly A Gaines Counseling
Kimberly A Gaines Counseling
New Client Paperwork
Client Intake Form, pp. 1-3
(docx)
Download
Client Intake Form, p. 4
(xlsx)
Download
Informed Consent
(docx)
Download
Notice of Privacy Practices
(doc)
Download
Insurance Information
(docx)
Download
Credit Card Authorization
(docx)
Download
Release of Information
(docx)
Download
Copies to Keep Notice
(docx)
Download
Informed Consent CLIENT COPY
(docx)
Download
Notice of Privacy Practices CLIENT COPY
(doc)
Download
Copyright © 2018 Kimberly A. Gaines Counseling - All Rights Reserved.
About
Contact