Licensed Psychologist PY5484
14521 Walsingham Rd, Largo, FL727.517.1938 FAX 727.517.1937
Home Video Therapy Downloads Privacy Notice
Patient Documents
Please download, fill out and FAX to 727-517-1937.
New Patient Packet (All Documents)
Download All
Individual Forms:
Appointment policies, fees and agreements
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Confidentiality and Emergency Procedures Form
New Client Information
Client Notice of Privacy Practices
Good Faith Estimate
Psychotherapist Patient Agreement
Authorization to release information
