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    202 Soundview Avenue | Stamford, CT 06902
    judith.revisiontherapy@gmail.com
    (203) 274-4284

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    • About
      • Judith Croen, LCSW
      • Testimonials
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      • Integrative Psychotherapy
      • Transformative Hypnotherapy
      • Life Coaching
    • Getting Started
      • FAQs: Psychotherapy
      • FAQs: Hypnotherapy
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    Client Forms

    If you are a new client please be sure to fill out the appropriate forms and bring them in to your first session.  This will allow as much time as possible to be spent focusing on you when we meet.

    Psychotherapy:

    Psychotherapy Intake Form

    Psychotherapy Private Pay Financial Agreement & Consent form,

    Psychotherapy Insurance Client Financial Agreement & Consent form

    HIPAA Agreement

    Release of Information

    Hypnotherapy:

    Hypnotherapy Intake & Consent Form

    Coaching:

    Coaching Intake & Consent Form

    Contact Today



    202 Soundview Avenue
    Stamford, CT 06902

    (203) 274-4284
    judith.revisiontherapy@gmail.com

    Contact Today

    By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

    reVision Studio LLC

    judith.revisiontherapy@gmail.com

    (203) 274-4284

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    Tap Here For Menu
    • Home
    • About
      • Judith Croen, LCSW
      • Testimonials
    • Services Provided
      • Integrative Psychotherapy
      • Transformative Hypnotherapy
      • Life Coaching
    • Getting Started
      • FAQs: Psychotherapy
      • FAQs: Hypnotherapy
      • Psychotherapy Rates and Payment
      • Hypnotherapy Rates and Payment
      • Coaching Rates and Payment
      • Client Forms
      • Appointment Request
    • Resources
      • Recent News
      • Mental Health Links
      • Physical Health Links
    • Contact
    • Blog