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New Beginnings Behavioral Health

My WordPress Blog

Client Forms

If you are new, please be sure to fill out the following forms, and bring them to your first session. This will help ease you in and allow as much time as possible to focus on you.

Client Intake Form

Information Sheet

Limits of Confidentiality

Authorization for Release of Information (optional)

Contact Today

125 St Andrews
Smithfield, VA 23430

(413) 563-3863
erin.m.casper@gmail.com

By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

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