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To ensure confidentiality and informed consent, please do not reach out on behalf of a loved one without that person’s consent. Instead, encourage them to fill out this form themselves, or with you.
For couples, polycules, families, etc., please include contact information for all people who will be participating in therapy. I will reply to all provided email addresses.
Remember, this is not a HIPAA-compliant mode of communication, so please be mindful if sharing any personal or medical information.