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CHILD THERAPY INTAKE FORM - Blake Psychology

Blake Psychology: Montreal 2001 University street, Suite 1700 Montreal, QC H3A 2A6 www.blakepsychology.com T: 514-319-1744 F: 1-877-417-4420 CHILD THERAPY INTAKE AND CONSENT FORM, Page 2 of 8 (Pages 1-7 are for the client’s file at Blake Psychology, page 8 is the parent/gaurdian’s copy of consent form)

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