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Beth Janczak, LCSW
Amber Rakoczy, LCSW
Paula Flynn, LPC
Shannon Hill, LCSW
Ana Maroon, LCPC
Laura Miller, LPC
Jessica Smith, LCSW
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Forms
Please fill out this form and bring it in to your first appointment.
The first five forms are all fillable right on your screen once you click the image(s) below. The HIPAA form is not fillable, but do download, print and bring with you.
Home
Who We Are
About
Meet our Team
>
Beth Janczak, LCSW
Amber Rakoczy, LCSW
Paula Flynn, LPC
Shannon Hill, LCSW
Ana Maroon, LCPC
Laura Miller, LPC
Jessica Smith, LCSW
Counseling
Women
Postpartum & Motherhood
Children/Teens
Workshops
Summer Teen Group
Resources
Work With Us
Careers
Consultation Group
>
Registration
Blog
Contact
Forms
Insurance/Payment/Good Faith Estimate
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Leona Martin