Sam Peters, LPC & Rooted Counseling & Wellness: Group Info/Registration Form
This form is for informational purposes only & does not indicate or represent a commitment by any person to any action of any kind beyond that purpose. We take our responsibility for HIPAA compliance very seriously & abide by all aspects of law regarding privacy & security. All information gathered from this form is strictly confidential. It will kept secured physically by multiple levels of locking doors & drawers & digitally behind password protected accounts. It will only be seen by Sam Peters, LPC & necessary office staff. If you prefer to reach out to me in order to give me your information personally feel free to reach out to me at SamPetersLPC@gmail.com. We can set up a time over email to talk more privately, if you'd prefer that, as well.
