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New Client FormsThe In-Take form are available when you book an appointment with me here.
Current Client Forms
If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:
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Toltec Therapy
78115 Calle Estado Suite 201 La Quinta, CA 92253 Phone: (760) 834-9008 hdiaz@toltectherapy.com |