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If you're a new client, please complete the following forms and bring them to your first therapy session.
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If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:
Note: To download Adobe Acrobat Reader for free, click here.
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Lake City, FL 32025
email: heartcentered@shaledamirralcsw.com
Dr. Sha'Leda Mirra, PhD, M.Div., MS, LCSW, CAP
(352) 247-2383
Book Me for your next Mental Wellness Workshop!
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