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Treatment/Therapy Forms
Teletherapy consent
This is a Paragraph. Click on "Edit Text" or double click on the text box to start editing the content and make sure to add any relevant details or information that you want to share with your visitors.
Credit card authorization
This is a Paragraph. Click on "Edit Text" or double click on the text box to start editing the content and make sure to add any relevant details or information that you want to share with your visitors.
Payment form
Use this form to submit credit card payment for your therapy appointment or to indicate your desire to pay cash or check. This form will generate an invoice/receipt for your records. (please note that your check number is required on this form).
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