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2600 North Reynolds Road, Toledo, Ohio 43615, United States Suite 101A

New Client Forms

Once Cynthia has made contact with you and confirmed you are a good fit to become a new client, please complete the forms below.

Patient Registration (pdf)

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Consent for Treatment (pdf)

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Client History (pdf)

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Submit your New Client Forms Here

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2600 North Reynolds Road, Toledo, Ohio 43615, United States Suite 101A

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