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Get and Sign Documentation of a Psychological Psychiatric Disability DOC  Form

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Disabilities or who may serve as members of the diagnostic team. Diagnoses of psychiatric disabilities documented by family members will not be accepted. License State Name and Title Address Email Phone Fax Signature of Evaluator Date ALL DOCUMENTATION WILL BE HELD IN THE STRICTEST CONFIDENCE THANK YOU FOR YOUR ASSISTANCE IN PROVIDING THIS INFORMATION. Please returned this signed form to Polly B. Documentation of a Psychiatric or Psychological Disability At Sarah Lawrence College students who...
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