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AUTHORIZATION TO RELEASE INFORMATION NAME___ DOB ___ I hereby authorize Claudia Swonger, LMHC To DISCLOSE to: And/OR To OBTAIN from: Name of Person or Organization: ___ Address___ ___ Fax #: ___ Phone
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Claudia Swonger, MA, LMHC refers to a licensed mental health counselor who has a master's degree and is qualified to provide mental health services.
Individuals seeking mental health services from Claudia Swonger, MA, LMHC may be required to provide relevant personal and insurance information.
To fill out the necessary forms for services with Claudia Swonger, MA, LMHC, clients typically need to provide personal information, treatment history, and insurance details.
The purpose of Claudia Swonger, MA, LMHC is to provide mental health counseling and support to individuals facing psychological challenges.
Clients must report personal identification details, medical history, and any insurance information when engaging with Claudia Swonger, MA, LMHC.
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