Jerome P. Rubin, LICSW
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Documents

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Prior to your first appointment, it may be helpful to download, print, and fill out the appropriate forms. The forms are in .pdf format.

Individual Agreement

Couples Agreement

Family Agreement

Agreement Letter for Teens

Parent Agreement Letter

Co-Ed Group Agreement Letter

Men’s Group Agreement Letter

Authorization to Receive-Release Information

Client Information

HIPPA Agreement

  • Group Schedule

  • June 2023
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Jerome P. Rubin, LICSW
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