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WebBirmingham, AL 35242. ADULT Intake Questionnaire. Patient Name: Date: Date of Birth: _____/_____/_____ Age of Patient: _____ PRESENTING PROBLEMS

Actived: 5 days ago

URL: https://www.childadolescentpartners.com/adult%20intake%20form.doc

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Web· Judicial and Administrative Proceedings – If you are involved in a court proceeding and a request is made for information about your diagnosis and treatment and the records …

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Client Information

WebClient Information. Please call Beth or Andon to schedule the initial appointment. Beth (c) 205-492-2426. Andon (c) 205-451-6496. Initial Assessment - 160.00. Individual 1hr …

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