PATIENT FORMS

---

Authorization to Obtain and Release Protected Health Information​

Professional Disclosure Statements for LCMHC Providers

• Mackenzie Almond, MA, LCMHC, CGP
• Dianne Babcock, MA, LCMHC, NCC
• Brice Bradshaw, LCMHC

---

almond_pds_072424.pdf
File Size:	273 kb
File Type:	pdf

Download File

---

babcock_pds_072424.pdf
File Size:	444 kb
File Type:	pdf

Download File

---

bradshaw_pds_072424.pdf
File Size:	452 kb
File Type:	pdf

Download File

---