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Phone: 619-281-6414
STEVEN M HIRSCH,PH.D. & ASSOCIATES
Clinical Psychology PSY6257  

5333 Mission Center Rd
Suite 100
San Diego, CA 92108

Phone: 619-281-6414
Fax: 619-542-1317

info@stevenhirschphd.com
http://www.stevenhirschphd.com

To make payment by credit or debit card, just click the PayPal image below. When you are directed to the PayPal website, enter in the agreed upon billing charges in the "Price" box. There is no additional charge to you for this service. PayPal is a widely used secure online payment service.

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Welcome to Our Practice

Dear Client
Welcome to our practice! If you are reading this page, you have probably made the decision to take a very important step. We want new clients to be well-informed about the way we run our practice. The following information is presented so that we may begin helping you solve your problems as soon as possible. For that reason, we have developed an orientation program that we would like you to complete before the first meeting. This should only take you about 10 minutes to complete, but will save us spending that time during your first session. We are hopeful that this will answer many of your questions in advance and we encourage you to talk with us about anything that is not perfectly clear.

Each of these forms needs to be reviewed, printed out and completed. Bring them to your first visit!
Forms to Bring to the First Session

Intake Form- This 2 page form provides us with your basic information and begins to give us an idea of the issues you would like to discuss.

Informed Consent- This 4 page document tries to answer frequently asked questions about therapy, confidentiality and how we run our practice.

Payment Policies- This 1 page form describes our payment policies.

Credit Card Payment Form- This 1 page form gives your consent for us to bill your credit card for authorized services.

We look foward to meeting you in person! Thank You!

Only fill one of these forms if you are directed by a staff member of Advanced Health Care.

Intake Questionnaire

Chemical Dependency Questionnaire