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Services Agreement and Disclosure Statement Km Spring Thompson, PSD, LLC Licensed Clinical Psychologist, Colorado License # 3555Doctorate of Psychology, University of Denver, 2009 Master’s Degree,
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Begin by gathering all necessary personal information such as full name, date of birth, and contact details.
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Indicate any relevant work experience, including job titles, responsibilities, and dates of employment.
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Include any professional certifications or licenses held, providing details of the issuing authority and expiration dates.
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Provide a detailed account of your clinical experience, including the settings in which you have worked and the populations you have served.
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Include any research or scholarly activities you have undertaken, including publications, presentations, or collaborations.
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Detail any professional memberships or affiliations you hold, including dates of membership and any leadership roles.
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Provide references from individuals who can speak to your professional qualifications and character.
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Review the completed form for accuracy and completeness before submitting it.
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Submit the filled out Kym Spring Thompson PsyD form through the designated submission method indicated by the organization or institution.

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Kym Spring Thompson PsyD is a licensed clinical psychologist.
Individuals or organizations who have received services from Kym Spring Thompson PsyD may be required to file for insurance or reimbursement purposes.
To fill out Kym Spring Thompson PsyD, you will need to provide details of the services received, dates of sessions, payment information, and any insurance details.
The purpose of Kym Spring Thompson PsyD is to document the psychological services provided to clients for billing, insurance, and treatment purposes.
Information such as patient name, date of birth, dates of sessions, type of services provided, billing codes, payment information, and insurance details must be reported on Kym Spring Thompson PsyD.
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