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MERCY HOUSE OF MELVILLE, INC. 13180 Leslie Road, Suite 2 Melville, PA 16335 Phone 8143376180 Fax 8147247681 MERCY HOUSE INDIVIDUAL COUNSELING APPLICATION FORM Name Date of Birth Address Phone # Emergency
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Personal information: Start by filling out your personal information such as your full name, contact details, and any other details required.
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Purpose of counseling: Specify the reason for seeking counseling, whether it's for personal issues, academic guidance, career advice, or any other relevant concern.
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Date and time preference: Indicate your availability for counseling sessions by selecting your preferred days and time slots.
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Emergency contact details: Provide the name, relationship, and contact information of a person to be contacted in case of an emergency during the counseling session.
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Form counseling centre is a document used to report information related to counseling services provided.
Counseling centres and organizations offering counseling services are required to file form counseling centre.
Form counseling centre can be filled out by providing details of counseling services offered, number of clients served, and any other relevant information.
The purpose of form counseling centre is to ensure transparency and accountability in the provision of counseling services.
Information such as types of counseling services provided, number of clients served, and qualifications of counselors must be reported on form counseling centre.
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