Joumas Consulting

George J. Joumas, M.A., L.P.C.

Document Download


Forms and Documents for:

 

 Joumas Consulting

 

4545 East Shea Blvd., Suite 112

Phoenix, Arizona 85028

 

PDF File

        Microsoft Word form fill file

 

These Adult packets includes:

Personal Data Sheet, Informed Consent for Treatment, Personal Intake / History (2 pgs), Authorization for Release and / or Exchange of Information. (Adult patients need to fill out all these forms (you may skip the authorization form until you meet with me)).

 

Please Read this HIPAA Notice of Information Practices and Privacy Statement. YOU WILL BE ASKED TO SIGN ON THE CONSENT FOR THAT YOU HAVE READ THIS HIPPA NOTICE. You do not need to print it our unless you want it for your records

PDF File 

 

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