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SarahScottDooling, LCSW 1855FirstAvenue Suite103 San Diego,CA92101 www.sarahscottdooling.comCONSENT FOR RELEASE OF PROFESSIONAL INFORMATIONPatients Name:___Date of birth: ___I hereby authorize Sarah
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Sarah Scott Dooling LCSW is a licensed clinical social worker.
Licensed clinical social workers who are certified by LCSW.
Sarah Scott Dooling LCSW form can be filled out online or by mail with the required information.
The purpose of Sarah Scott Dooling LCSW form is to report information about licensed clinical social workers.
Information such as name, license number, contact information, and any disciplinary actions must be reported on Sarah Scott Dooling LCSW form.
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