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UTA Russell, LCSW 717 7th Street Davis, CA 95616 Phone: (530) 4004082 Fax: (530) 3410614 Email: uta.russell.lcsw@gmail.com INFORMED CONSENT ADDENDUM FOR TELEHEALTH TREATMENT PLEASE SIGN Definition:
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Uta Russell LCSW Licensed Clinical is a type of license granted to Uta Russell who is a licensed clinical social worker.
Uta Russell or any other individual holding the same type of license is required to file Uta Russell LCSW Licensed Clinical.
To fill out Uta Russell LCSW Licensed Clinical, one must provide all required information accurately and completely as per the guidelines provided.
The purpose of Uta Russell LCSW Licensed Clinical is to ensure that individuals holding this license are authorized to practice as licensed clinical social workers.
Information such as license number, expiration date, renewal date, and any additional details required by the licensing board must be reported on Uta Russell LCSW Licensed Clinical.
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