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Teletheraphy Consent

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Consent to Treatment
Billing and Insurance Info
Teletherapy Consent
Client Information
Client Email/Texting Informed Consent
Adult Psychosocial History
(over 18 years old)
OR
Child/Adolescent Psychosocial History
(under 18 years old)

Covid-19 Liability Waiver
Release of Information

Life Cyle Family Counseling, Inc. • 39293 Plymouth Road, #110 • Livonia, MI 48150 • (734) 462-4999