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Please download, print (double-sided is fine), and complete these documents prior to your first session. Please bring them with you or email them to me at imclmft@gmail.com. If we are meeting via telehealth, please complete and email them to me at imclmft@gmail.com.  Only sign the Release of Information form *if* you'd like me to share your information.  Thank you!
intake_forms_v11042020_.pdf
File Size: 407 kb
File Type: pdf
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intake_espanol_v08272020.pdf
File Size: 310 kb
File Type: pdf
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Inspired Mind Counseling
Madeleine Burkhart, MS, JD, LMFT 

(925) 528-1363

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