Sullivan Moseley, Ph.D., LPC, NCC Moseley & Associates Exclusive Counseling Services

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Dr. Sullivan Moseley
(704) 927-9202
sullivan@sullivanmoseley.com
Helpful Forms

If you're a new client, please complete the following forms and bring them to your first session.

  • Client Intake Form
  • Limits of Confidentiality/Cancellation Policy Form

 

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form:

  • Consent to Release Information Form

 


Client Intake Form
Confidentiality and Cancellation Policy
Consent to Release

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