STACEY BLOCK, LMSW, ACSW, PLLC Individualized Psychotherapy & Life Coaching for Children, Adolescents and Adults

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Stacey Block, LMSW, ACSW
(248) 593-5088
999 Haynes, Suite 345
Suite 345
Birmingham, MI 48009, MI 48009
stacey@staceyblocktherapy.com
Helpful Forms

If you're a first-time client, please review and complete the following forms, 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, endocrinologist, etc.), complete this form:

  • Consent to Release Information Form

 


Client Intake Form
Confidentiality and Cancellation Policy
Consent to Release

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