NC Kelly Harrison MACC LPCA LMFTA Client Disclosure Statement 2014-2025 free printable template
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Kelly Harrison, MAC, SPCA, LEFT 505 Oberlin Road, Suite 110 Raleigh, NC 27605 9192723139 Client Disclosure Statement (Information and Consent for Treatment) I am pleased that you have chosen me for
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How to fill out NC Kelly Harrison MACC LPCA LMFTA
How to fill out NC Kelly Harrison MACC LPCA LMFTA Client
01
Start by downloading the NC Kelly Harrison MACC LPCA LMFTA Client form from the official website or obtain a physical copy.
02
Read the instructions provided with the form to understand the required information.
03
Fill in personal information including your name, address, contact number, and date of birth in the designated sections.
04
Provide any relevant insurance information if applicable.
05
Indicate any previous mental health treatment or counseling you have received.
06
Complete sections regarding your current concerns, symptoms, and goals for therapy.
07
Sign and date the form to verify the information provided is accurate.
08
Submit the completed form to your therapist or the appropriate office as instructed.
Who needs NC Kelly Harrison MACC LPCA LMFTA Client?
01
Individuals seeking mental health counseling services.
02
Clients looking to work with a licensed therapist or counselor in North Carolina.
03
Those requiring assessment for therapy or support related to mental health issues.
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What is NC Kelly Harrison MACC LPCA LMFTA Client?
NC Kelly Harrison MACC LPCA LMFTA Client refers to a specific client record or case handled by Kelly Harrison, who is a licensed professional counselor associate (LPCA) and licensed marriage and family therapy associate (LMFTA) in North Carolina.
Who is required to file NC Kelly Harrison MACC LPCA LMFTA Client?
The filing is typically required for licensed mental health professionals, such as Kelly Harrison, to report client information for administrative or clinical purposes in accordance with state regulations.
How to fill out NC Kelly Harrison MACC LPCA LMFTA Client?
Filling out the NC Kelly Harrison MACC LPCA LMFTA Client involves collecting necessary client information, including demographic details, treatment plans, and progress notes, and entering it into the appropriate forms or electronic health records system as per state guidelines.
What is the purpose of NC Kelly Harrison MACC LPCA LMFTA Client?
The purpose of NC Kelly Harrison MACC LPCA LMFTA Client is to maintain accurate records of client therapy sessions, track progress, ensure compliance with legal requirements, and provide effective mental health care.
What information must be reported on NC Kelly Harrison MACC LPCA LMFTA Client?
Information that must be reported includes client identification details, assessment information, treatment goals, session dates, therapeutic interventions used, and progress updates.
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