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Phone 402-991-0611 | Fax 402-991-6228 | Email: Charles@Spence.omhcoxmail.com
Spence Counseling Center | 12035 Q Street | Omaha | NE | 68137
Client Insurance Fee Agreement.pdf
Release of Confidential Information.pdf
Client Outpatient Benefits.pdf
Client Information
HIPAA Short Notice.pdf
Consent to Treat Receipt NPP.pdf
Updated Client Information
Shortened Notice of Privacy Practices.pdf
Card on File Agreement
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