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    • Psychological Testing
    • Mental-Health Therapy
    • School-Based Therapy
    • Addiction Education
    • Immigration Waiver
    • ARMHS
    • Release of Information
  • Our Team
    • Leadership
    • Our Staff
    • Available Positions
  • Contact us
  • Resources
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Authorization to Share Information

To ensure we provide the best care possible and coordinate with the appropriate individuals or organizations, please complete the following Release of Information form(s). This allows us to share relevant details with those you choose and only with your written consent.

Release of Information (ROI) - Printable (pdf)Download
Release of Information (ROI) - Fillable (pdf)Download

ONCE COMPLETED PLEASE SUBMIT THE FORMS TO US!

 You can submit completed forms by:
• Emailing them to: INFO@VEEMAHCONSULTING.COM
• Faxing them to: 763-355-5718
• Drop them off at our office, please call ahead to ensure staff are available to receive the form. 


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VEEMAH CONSULTING

5701 Kentucky Ave Suite 100 Crystal, MN 55428

Phone: 763-202-4767 | Fax: 763-355-5718

Copyright © 2018 Veemah Integrated Wellness and Consulting Services LLC - All Rights Reserved.