Confidential Client Information

REGISTRATION FORM

Welcome to The International Psychology Clinic. We want to make the most of each appointment you have with us.

One way of doing this is for you to write down some basic information in advance of your first appointment.

Please fill out the following as completely as possible. This information is confidential.  If you have concerns about the relevance of any information and wish to leave it out, please feel free to do so.

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