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Contract Type FiledMay 6th, 2021The 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.
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.
Telehealth Counseling AgreementTelehealth Counseling Agreement • January 29th, 2021
Contract Type FiledJanuary 29th, 2021
TELEHEALTH (VIDEO/PHONE) COUNSELING AGREEMENTTelehealth Counseling Agreement • May 27th, 2024
Contract Type FiledMay 27th, 2024The 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.
TELEHEALTH COUNSELING AGREEMENTTelehealth Counseling Agreement • September 18th, 2019
Contract Type FiledSeptember 18th, 2019