Hollywoodpsychologycenter.com

Hollywood Psychology Center

WebHollywood Psychology Center is a uniquely comprehensive facility dedicated to helping individuals and families who are seeking understanding and change. We treat most …

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URL: https://www.hollywoodpsychologycenter.com/

Hollywood Psychology Center

WebOur psychologists are highly skilled and experienced in conducting neuro-psychologoical assessments and batteries, giving accurate diagnoses, recommending individualized …

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Hollywood Psychology Center

WebHollywood Psychology Center Educational Assessments of Children & Adolescents. For students who are having trouble keeping pace in key areas, educators will often suggest …

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Consent to Evaluation and Treatment

Web3475 Sheridan Street, Suite 309, Hollywood, FL 33021 | 954-981-8200 tel 954-381-5979 fax Consent to Evaluation and Treatment Welcome to Hollywood Psychology Center.

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Hollywood Psychology Center Hollywood

WebHollywood Psychology Center 3595 Sheridan St., Suite 103, Hollywood, FL 33021 | Phone: 954-981-8200 Medical History Does the child have any significant health problems? No …

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Coordination of Care between Health Care Providers and …

Web3475 Sheridan Street, Suite 309, Hollywood, FL 33021 954-981-8200 tel 954-272-8043 fax Coordination of Care between Health Care Providers and Release of Information

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NOTICE OF PRIVACY PRACTICES

Web- 2 - has the necessary information to diagnose or treat you. In addition, we may disclose your protected health information from time-to-time to another physician or health care

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Hollywood Psychology Center Hollywood

WebHollywood Psychology Center Hollywood 3595 Sheridan St., Suite 103, Hollywood, FL 33021 | Phone: 954-981-8200 Psychology Center 3595 Sheridan St., Suite 103, …

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Acknowledgment of Receipt of Notice of Policies and Privacy …

WebSerious Threat to Health or Safety: When you present a clear and immediate probability of physical harm to yourself, to other individuals, or to society, I may communicate

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Hollywood Psychology Center Hollywood

WebHollywood Psychology Center 3595 Sheridan St., Suite 103, Hollywood, FL 33021 | Phone: 954-981-8200 Assignment of Insurance Benefits The undersigned hereby authorizes the …

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Confidential Youth Intake Information Questionnaire

Web3475 Sheridan Street, Suite 309, Hollywood, FL 33021 | 954-981-8200 tel 954-381-5979 fax Confidential Youth Intake Information Questionnaire (Child to Fill Out)

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Confidential Client Intake Information Questionnaire

Web3475 Sheridan Street, Suite 309, Hollywood, FL 33021 | 954-981-8200 tel 954-381-5979 fax Confidential Client Intake Information Questionnaire Name Age Birthdate

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Authorization of Release of Protected Health Information

Web3475 Sheridan Street, Suite 309, Hollywood, FL 33021 954-981-8200 tel 954-272-8043 fax Authorization of Release of Protected Health Information

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Youth Intake Questionnaire for Parents/Guardians

Web3475 Sheridan Street, Suite 309, Hollywood, FL 33021 | 954-981-8200 tel 954-381-5979 fax Youth Intake Questionnaire for Parents/Guardians Child’s name Age Birthdate

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