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Christi Chairman, MS, MHC 180 Nickerson St Ste. 303 Seattle WA 98109 (206) 3523752 www.cthielman.com Credit Card Authorization Form Client Name: Date of Birth: This document authorizes Christi Chairman,

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What is cristi thielman ms lmhc?

Cristi Thielman MS LMHC is a licensed mental health counselor specializing in providing therapy services.

Who is required to file cristi thielman ms lmhc?

Cristi Thielman or any mental health counselor with similar qualifications may be required to file this document.

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The form can be filled out by providing personal information, qualifications, therapy services offered, and any other relevant details.

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The purpose of this form is to report the qualifications and services offered by a mental health counselor like Cristi Thielman.

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Information such as qualifications, therapy approach, specialties, contact information, and any other relevant details must be reported.

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