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LORI RAPPAPORT, Ph.D. 1265 High Bluff Dr. Suite 201 * San Diego, CA 92130 Telephone: (858) 4812188 * FAX (858) 7925095AUTHORIZATION FOR RELEASE OF INFORMATION I, ___ hereby authorize Dr. Lori Rappaport
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Dr. Lori Rappaport offers psychotherapy services.
Individuals who are seeking psychotherapy services.
You can fill out the form by visiting Dr. Lori Rappaport's office or contacting her for more information.
The purpose is to provide individuals with professional psychotherapy services to address their mental health needs.
Personal information, reason for seeking therapy, medical history, and any other relevant details.
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