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PART ONE KEEP FOR PERSONAL RECORDS(print color, front to back)Department of Psychology Behavioral Health and Wellness Clinic Box 70416 Johnson City, Tennessee 37614 4234397777 (phone) 4234397780 (fax)Hello,
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Part one keep is used for reporting basic information about an individual.
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All individuals who are employed are required to file part one keep.
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Information such as name, date of birth, address, and social security number must be reported on part one keep.
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