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Consent for Intensive Outpatient/Outpatient Mental Health and Dietary Treatment 1. Consent to Evaluate/Treat: I voluntarily consent that I will participate in a mental health (e.g. psychological,

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Chapter 4 services are related to the reporting and withholding requirements for certain payments to foreign entities.

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Information regarding payments to foreign entities, withholding amounts, and recipient details must be reported on chapter 4 services.