Home Page
My Journey
What is Imago
Individuals
Couples
Forms
Self Assessment
Contact Me
MY POLICIES / CONSENT FOR TREATMENT - INDIVIDUAL
New Patient Information
|
Policies/Consent Form (Couples)
|
Policies/Consent Form (Individual)
|
Medical Log Form
Click here
to print form | To open entire form in new window
Click here
Click here
to print form
Dita Teitelbaum, MSW LCSW
14440 SW 80th Avenue
Miami, FL 33158
Phone: 305-251-8609
Fax: 305-251-8609