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Psych Industries

Counselling consent and intake form for minors

Please answer the following questions to the best of your ability. These questions are to help the practitioner(s) with the mental health process. This information is held to the same standards of confidentiality as our therapy. 

These services will be rendered by Imeraan Isaacs

0649068277, imeraan@psychindustries.online

Psych Industries (Pty) Ltd. 

Registration Number: 2021/735894/07

SECTION C:Parent/Guardian Information

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Registration Number: 2021/735894/07 Enterprise Name: Psych Industries (Pty) Ltd

©2024 by Psych Industries.

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