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Potential Clients
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Size of Household: Select One
Ok to Leave a Message
I am Interested in: Choose One
The Primary Concern I Would Like to Talk Abot in Counsling is: Choose One
Selecting any of these may mean that yo are otapprpriate for participaton
Have you been hospitalised in te last 6 mos due to metal health concerns?
Are you taking or have you taken medications to address your mena health concerns
Are you seekin treatment fo alcohol or drug use?
Do you have health insurance
Are you seekin treatment mandated by the court or do you need an assessment?

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