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Forms Please sign indicated forms. Hippa is for your information

richmond_square_ppractices_acknow.doc (23.5 KB)

PLEASE SIGN YOU HAVE RECEIVED MY HIPPA PRIVACY PRACTICES POLICY

richmond_square_privacy_practice_doc.docx (16.6 KB)

FOR YOUR INFORMATION PRIVACY PRACTICES DO NOT SIGN

teletherapy_release_richmond_sq.doc (30.5 KB)

PLEASE SIGN OFFICE POLICY/TELETHERAPY RELEASE

authorization_for_release_of_limited_information.docx (13.7 KB)

PLEASE SIGN AUTHORIZATION TO BILL YOUR INSURANCE