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Rockville Psychotherapy Associates Logo Rockville Psychotherapy Associates Logo
  • Who We Are
    • Vivian Levi
    • Marina Tudor
    • Leon Suskin
    • Marja Booker
    • Amihan Kernan
    • Amanda Smith
  • What We Do
    • Individual Therapy
    • Couples Therapy
    • EMDR Therapy
    • Parenting Agreements
    • Anger Management Classes
    • Immigration Affidavits
    • Supervision
  • Get Started
    • Patient Forms
    • Fees & Insurance
    • Office Location
  • Resources
  • Patient Portal
  • Contact Us
  • Who We Are
    • Vivian Levi
    • Marina Tudor
    • Leon Suskin
    • Marja Booker
    • Amihan Kernan
    • Amanda Smith
  • What We Do
    • Individual Therapy
    • Couples Therapy
    • EMDR Therapy
    • Parenting Agreements
    • Anger Management Classes
    • Immigration Affidavits
    • Supervision
  • Get Started
    • Patient Forms
    • Fees & Insurance
    • Office Location
  • Resources
  • Patient Portal
  • Contact Us
 

240-286-5486
info@rockvillepsychotherapyassociates.com

Patient Forms

Patient FormsAmyAdminVivian2021-10-25T13:00:23-04:00
  • New Client Registration Form
  • Returning Client Registration Form
  • Authorization for Release of Information
  • Parental Consent for Mental Heath Treatment of a Minor
  • Insurance Information
  • Payment Information
  • Teletherapy Treatment Contract
  • EMDR Consent to Treatment

Contact Us

240-286-5486
info@
rockvillepsychotherapyassociates.com

Our Office

1680 East Gude Drive
Rockville, MD 20850

 

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We offer teletherapy on HIPAA compliant platforms.
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