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+1-772-310-3074

Gold Center for Mental Heatlh
  • Home
  • Patient Forms

PATIENT FORMS

Dr Gold HIPPA (pdf)Download
Dr Gold New Consents (pdf)Download
Dr Gold Notice of Information Practices (pdf)Download
Dr. Gold Statement of Financial Responsibility (pdf)Download
Dr Gold Telehealth Consent Form (pdf)Download
Dr Gold Email Consent Form (pdf)Download
Dr Gold Authorization For Release of Mental Health Record (pdf)Download
Dr Gold Consent for Use of AI Scribe Technology in Psychological Services (pdf)Download
Dr. Gold New Patient Intake Form (pdf)Download

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