Mindful DBT, LLC  "Live This Moment"  
Amber M Chan, LPC-MH, QMHP   
DBT-Linehan Board of Certification, Certified Clinician™

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Forms



Patient Registration


Mental Health- Intake


HIPAA Notice


BSL-23


DAST


MAST


PSS-I




Please Print and Complete these forms and bring them to your first session


OR


Plan of Arriving to your first session 30 min early to complete this paperwork at that time