Standard Authorization of Disclosure Form

A circular logo with a blue watercolor background, featuring the text 'BE HERE NOW' with an arrow and a heart, promoting mindfulness and compassion training.

Let’s work together.

Jennifer Finch, M.A., LPC, NCC, SEP

jencfinch@gmail.com

www.beherenowmindfulness.com

678-428-2730

Interested in working together? Please contact me for an initial screening before completing these forms.

Standard Authorization Disclosure Of Mental Health Treatment Information