Jeffrey Levy, LCSW
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  • Home
  • About
  • Services
    • Psychotherapy
    • Consultation
    • Training
  • Writing
    • Blog
    • Other Publications
  • Forms
  • No Surprises Act
    • A Note About the No Surprises Act
    • Your Rights and Protections
    • Good Faith Estimates
  • Contact
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FORMS

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Forms

​Psychotherapy Statement of Agreement
psychotherapy_soa_2022.pdf
File Size: 210 kb
File Type: pdf
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​Telemental Health Statement of Agreement
telemental_health_soa_2022-2023.pdf
File Size: 205 kb
File Type: pdf
Download File


​HIPAA Guidelines and Acknowledgment
hipaa_guidelines_and_acknowledgment.pdf
File Size: 254 kb
File Type: pdf
Download File

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(c) 2018  Jeffrey Levy LCSW LLC