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Stephanie Schiller MSW LCSW CREDIT CARD AUTHORIZATION FORM By signing this form I understand that Stephanie Schiller MSW LCSW will be billing my insurance company on my behalf for therapeutic services. I also understand that Stephanie Schiller MSW LCSW is billing my insurance as a courtesy to me as opposed to me paying upfront for services upfront and waiting to be reimbursed by the insurance company. In addition Stephanie Schiller MSW LCSW will charge my credit card for charges which I have...
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