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Carol R. Hirshfield, PhD A Psychological Corporation

310-473-3200

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Forms

Authorization to Consult with Other Professionals
Authorization to Use Credit Card for Payment
Collaborative Divorce Informed Consent Agreement
Custody Mediator Agreement
Psychotherapist Agreement
Enrollment Form for Co-Parenting Class (COPE)
Cope Class Outline
Client Contact Infromation Sheet
Family Therapy Agreement
Informed Consent for Video-Conferencing Services
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Email: drcarol@drcarolhirshfield.com

Phone: 310-473-3200

Los Angeles Address

10801 National Blvd, Suite 221

Los Angeles, CA 90064

Seattle Address

1307 North 45th Street, Suite 200

Seattle, WA 98103

© Carol R. Hirshfield, PhD 2020

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