Kimberly Shannon, M.A.

License Number: LMFT23791

Forms

Authorization for Release of Information

Patient Questionnaire Intake

Client Policy Letter

Telemedicine Consent Form

Intake Form

HIPAA NOTICE OF PRIVACY PRACTICES with Acknowlegment of Receipt

18525 Sutter Blvd., Ste. 200, Morgan Hill, CA 95037

License Number: LMFT23791

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