Free Telephone Consultation (419) 434-1254

Stephanie Souza
Licensed Independent Social Worker

Stephanie Souza Licensed Independent Social WorkerStephanie Souza Licensed Independent Social WorkerStephanie Souza Licensed Independent Social Worker

Stephanie Souza
Licensed Independent Social Worker

Stephanie Souza Licensed Independent Social WorkerStephanie Souza Licensed Independent Social WorkerStephanie Souza Licensed Independent Social Worker
  • Home
  • Client Forms
  • About My Practice
  • About Me
  • Therapy Services
  • What is Therapy?
  • Questions?
  • Contact Me
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  • Blog
    • Home
    • Client Forms
    • About My Practice
    • About Me
    • Therapy Services
    • What is Therapy?
    • Questions?
    • Contact Me
    • Resources
    • Privacy statements
    • Blog
  • Home
  • Client Forms
  • About My Practice
  • About Me
  • Therapy Services
  • What is Therapy?
  • Questions?
  • Contact Me
  • Resources
  • Privacy statements
  • Blog

CLIENT COUNSELING FORMS: PLEASE READ AND SIGN AT THE APPOINTMENT

Insurance and demographics form (pdf)Download
client intake form (pdf)Download
consent to treat.docx (pdf)Download
Teletherapy Consent.docx (pdf)Download
COVID CONSENT.docx (pdf)Download
HIPAA privacy notice (pdf)Download
credit card (pdf)Download
Release of information (pdf)Download
parent agreement to privacy (docx)Download
GAD 7 (pdf)Download
Depression scale self assessment (pdf)Download

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Copyright © 2018 Stephanie Souza, LISW, LICDC, LLC - All Rights Reserved.




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