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1260 Old York Rd. War minster, PA office 2152930744fax 2152930745Client Consent Form AUTHORIZATION TO OBTAIN, DISCLOSE AND EXCHANGE PROTECTED HEALTH INFORMATION AUTHORIZATION The undersigned hereby
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Contact Airmid Wellness and Counseling is a service that provides mental health and wellness support to individuals.
Contact Airmid Wellness and Counseling may be required by individuals seeking mental health services.
Contact Airmid Wellness and Counseling can be filled out by contacting the service provider and scheduling an appointment.
The purpose of Contact Airmid Wellness and Counseling is to provide support and assistance for mental health and wellness.
Contact Airmid Wellness and Counseling may require personal information, mental health history, and current concerns to be reported.
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