Francis Private Therapy
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Francis Private Therapy
  • Home
  • Services
  • About
  • Contact
  • FAQs
  • COVID-19

Client forms

PLEASE DO NOT COMPLETE/SUBMIT ANY FORMS UNTIL YOU HAVE CONTACTED US BELOW TO VERIFY OPENINGS.

Initial Intake Form (pdf)Download
Confidentiality Cancellation Form (pdf)Download
Telehealth Consent Form (pdf)Download
In-Person Consent Form (pdf)Download

CONTACT FORM

COMPLETE THIS SECTION AND SUBMIT TO CHECK FOR OPENINGS. please note, we are an out-of-network provider. we can assist you in verifying your insurance benefits. evening appointments are limited and may not be available.

Attach Client Forms
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Location

73 Market Street 

Ridge Hill WestMed Building

Third Floor Suite 376

Yonkers, New York 10710

914.343.6306

Serving New Jersey residents remotely

Copyright © 2021 Francis Private TherapY,LCSW,PLLC - All Rights Reserved.