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262.528.2015 | erika@counselingtobloom.com

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Bloom Counseling LLC

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Client Forms

If you are new, please be sure to fill out the following forms, and bring them to your first session. This will help ease you in and allow as much time as possible to focus on you.

Client Intake Form

Information Sheet

Limits of Confidentiality

If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

Authorization for Release of Information

510 Hartbrook Drive Suite 201
Hartland, WI 53029

262.528.2015
erika@counselingtobloom.com

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