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Telephone:

678.523.0525

email:pjking@bellsouth.net

Polly J. King, M.A., Certified Professional Life Coach and Counselor

Insurance Form...all insurance covered clients please complete this form.

Informed Consent Form....required before counseling can commence.

Please choose one of the following appropriate forms to facilitate my review of your particular needs.

• Adult Information Form
• Couples Information Form
• Adolescent Information Form, (For Parents to Complete)
• Adolescent Sentence Completion (For Adolescent to Complete)