Rhoberta E Michaels LPC NCC CFRC/Peace & Light Psychotherapy LLCTelehealth Counseling Agreement • April 15th, 2022
Contract Type FiledApril 15th, 2022The purpose of this form is to obtain your consent to participate in telemental health, which involves counseling by phone, video, or secure online email portal.
Your Name Your Address, City, State Phone NumberTelehealth Counseling Agreement • April 24th, 2020
Contract Type FiledApril 24th, 2020The purpose of this form is to obtain your consent to participate in telemental health, which involves counseling by phone, video, or secure online email portal.