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Peter J. Chechele. MFT Lic #34470
140 Mayhew Way, Suite 602
Pleasant Hill, CA 94523
925-887-6742
 
Client Forms & Video Software

If you're a new client, please complete the following forms and bring them to your first therapy session or email them to me: peter@therapy4gamblers.com

  • Client Psychotherapy Intake Form
  • Limits of Confidentiality/Therapy Cancellation Policy
For clients who will be working with me via video conferencing please use either Skype or ooVoo.
  • Software download  Skype or ooVoo

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

  • Authorization to Disclose Information Form

Client Psychotherapy Intake Form  
Limits of Confidentiality/Therapy Cancellation Policy  
Authorization to Disclose Information Form  

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