Professional Disclosure and Consent for Therapy Form

This consent form provides you with more information about my credentials, your basic contact information, and the guidelines for our therapeutic relationship, including the limits to confidentiality required by law.

By signing it you agree that you understand and consent to therapy with me. You also understand that you may decide to terminate therapy at any time.

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It is only in being creative that the individual discovers the self.
— Donald Winnicott