Clinician Templates | CBPI

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Notification of Clinical Supervision
Price$10.00
Notification of Supervised Private Practice & Supervision
Price$10.00
Clinician Packet
Price$75.00
Informed Consent Template
Price$25.00
Critical Incident Report Template
Price$15.00
Release of Information Template
Price$15.00
Treatment Plan Template
Price$15.00
Progress Note Template
Price$15.00
Spreadsheet for Tracking Licensure Hours Only
Price$10.00
Couples Assessment
Price$25.00
Caseload Transition Spreadsheet Only
Price$10.00

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*To avoid any conflicts of interest or appearance of a conflict, I’m currently unable to provide consultative or supervision services to those with an open Arizona Board of Behavioral Health Examiners investigation, pending complaint, or in relation to a consent agreement.

*Please avoid disclosing any client protected health information when completing a consultation form or in an email. If client protected health information needs to be disclosed during a consultation, a Business Associate Agreement will be completed to ensure confidentiality.

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