Psychologist Cleveland OhioDr. Richard Weisberg Psychologist

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Rich Weisberg, Psy.D. Therapist Lyndhurst Therapist
 

 

PATIENT FORMS:
Adult Paperwork:
ADOBE
PDF
Psychological Services Agreement - Adult

Background Information - Adult

Adult Consent to Treat

Notice of Privacy Practices

Insurance Paperwork:
Insurance Verification Script

Insurance Information Form

Authorization to Release Information:  
Authorization to Release Information

Credit Card Authorization Forms:
Credit Card Authorization Form - Telephone or e-Therapy

Credit Card Authorization Form - 1st Session, Bills, co-pay

Session Guarantee Contract