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COMPASSIONATE COUNSELING CENTER/JULIE RUSSELL FAMILY COUNSELING (Please Print)PATIENT REGISTRATION SHEET DX CODE:Today's Date:PATIENT INFORMATION Last Name:First:Street Address:City:Middle: Miss Ms.
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Contact Julie Russellformrapist psychoformrapist refers to a specific form or documentation that is related to the reporting or seeking help regarding issues of sexual assault or related crimes.
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The purpose of this form is to facilitate communication and reporting concerning incidents of sexual assault, ensuring that victims receive the necessary support and resources.
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The information typically required includes the victim's details, the perpetrator's information if known, a description of the incident, and any witnesses or evidence.
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