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Larchmont, New York 10538
(914) 315-4044 / F (914) 315-8266
FORMS

The following forms can be printed and filled out in advance or available to you at your first session.
All clients must fill out and sign the Client Information and Bill of Rights Form
If you would like to find out if you can receive some reimbursement through insurance, please contact my office or you can send me the information on the insurance form so that we can verify coverage.
I am an out-of-network provider for all insurance carriers except for Medicare.
I am an in-network provider for Medicare.
Please contact me with any questions. Thank you
Client Information
Client Bill of Rights - HIPAA
Health Insurance Information
Permission to Bill Health Insurance Company
Release of Confidential Information
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