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Patient and Referral Forms

Patient Self-Referral
We value your outreach for counseling at Credence Counseling Services and look forward to supporting your personal growth journey. Please feel free to take a moment to complete this brief self-referral form so our staff can determine how to best serve your unique growth and counseling needs. Referral forms may be returned to our primary email address at: credencereception@gmail.com
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*Notice: We apologize for any inconvenience, but this form is currently being reviewed and edited. We will have it available as soon as we can.
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