117 S. Saint Asaph Street, Alexandria, VA 22314
adminsupport@movingforwardplc.com
571.483.0306
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  • Home
  • About
    • Michele Cole, Ph.D., LCSW
    • Consultant Team
  • Therapy
    • Individual Therapy
    • Couples Therapy
    • Family Therapy
    • Group Therapy
    • Play Therapy
  • Resources
    • Groups
    • Books
    • Links
    • FAQ
    • Forms
      • Authorization to Release Information
      • HIPPA
      • Financial Agreement / Credit Card Authorization / Communication Consent
      • Good Faith Estimate Disclosure
  • Blog
  • Contact
571.483.0306, adminsupport@movingforwardplc.com

Financial Agreement / Credit Card Authorization / Communication Consent

HomeFinancial Agreement / Credit Card...

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Documents can be scanned and emailed directly to your therapist or to Francis, adminsupport@movingforwardplc.com; Or you can fax completed documents to 571-483-0356.

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Phone: 571.483.0306
Fax: 571.483.0356
117 S. Saint Asaph Street
Alexandria, VA 22314

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