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​​Kevin Brock, Ph.D.
Licensed Clinical Psychologist

Forms

If you are a new client, please complete the following forms and bring them to our first meeting: 

Client Information Brochure
Consent to Treatment 
Intake Information Form 
Release of Information

The following form must be signed and approved by you for me to release any of your treatment information. For example, if you want to coordinate our treatment with you personal physician, psychiatrist, or for legal reasons. 

Release of Confidential Records Form