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PATIENT/CLIENTINTAKEFORM Thefollowinginformationneedstobegatheredinorderforustoformulateasafeandeffectivesessionforyou. Thisinformationwillbekeptconfidentialandcannotbereleasedwithoutyourwrittenconsentunlessobligedby
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What is this information may be?
This information may be related to financial transactions or personal details.
Who is required to file this information may be?
Any individual or entity mandated by law to do so.
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