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CATHY PONCZEK

461 East Hillsboro Boulevard
Deerfield Beach, FL, 33441
Phone Number
Cathy Ponczek

CATHY PONCZEK

Licensed Marriage & Family Therapist


virtual sessions only

CATHY PONCZEK

  • FORMS
  • CONTACT ME
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FORMS

If you are a new client, please complete the following forms and bring them with you to your first appointment.  If you have a couples or family session scheduled, all members  are asked to complete forms.

 

Client Information Form     Client History     Insurance Information   Informed Consent

Financial Responsibility Agreement Payment Contract Teletherapy Consent