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Judith Margin, Pay. D Licensed Psychologist #349310 Boxwood Drive Tel: (609) 6582536 Princeton, NJ 08540Fax: (732) 3291634Authorization to Disclose PHI to Primary Care PhysicianClient Name: Date of
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Start by providing your personal information such as name, date of birth, and contact details.
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Provide information about any research work or publications you have done in the field.
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Mention any memberships or affiliations with psychology associations.
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Include any additional training or workshops you have attended.
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Submit the filled-out Judith Margolin Psy form as per the instructions provided.

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Judith Margolin Psy is a psychological evaluation conducted by Dr. Judith Margolin.
Individuals who are required to undergo a psychological evaluation as ordered by a court or other legal authority may need to file Judith Margolin Psy.
Judith Margolin Psy can be filled out by providing accurate and honest information about one's mental health and well-being.
The purpose of Judith Margolin Psy is to assess and evaluate an individual's mental health and psychological condition.
Information such as personal history, mental health symptoms, and any relevant medical history must be reported on Judith Margolin Psy.
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