If you have scheduled an appointment with Desiree, please complete the Online Pre-Registration.

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Pre-registration Form

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Complete all

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Disclosure Statement

HIPAA Form

Consent To Communicate PHI Electronically

Credit Card Authorization

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If you would like for me to have contact with a third party regarding your treatment please print and complete this release of information form.

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Release of Information Form

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Additional forms

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EMDR Consent Form

Permission To Video