Client Information Form
Please complete and send before your first appointment.
First and Last Name *
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Email *
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Date of Birth *
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Phone number *
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Time Zone *
Street Address, City, State, Zip Code *
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What would like your appointment to address? *
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Please mark all that you have been experiencing in the past 30 days:
How did you hear about Julie Davis, the Bay Area Center for Rapid Resolution Therapy and/or RRT?
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Would you like to receive Julie's Tuesday Articles by email?
What days/times are you available for your appointment? *
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Practice Policy:
Did you read and do you agree to follow Julie's practice policy? *
What else would be useful for Julie to know before your appointment?
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