Eva Moheban, LCSW
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Forms

Please fill out the applicable forms below and bring them
to your first therapy session. Thank you.

  • Eva’s Therapy Scale
  • Informed Consent – Adults
  • Informed Consent – Minors
  • Informed Consent – Couples
  • Intake Form – Couples Counseling
  • Notice of Privacy Practices
  • Release of Confidential Information

    • —

  • Client Intake Form
  • Credit Card Authorization Form
  • Limits of Confidentiality
  • Informed Consent
  • Cancellation Policy

Contact me today for your free consultation.

I can help you attain the personal growth you truly desire.

818-539-7383

FREE CONSULTATION

Eva Moheban, LCSW

Therapy For Every Woman

LOCATION:

17514 Ventura Blvd Suite #101
Encino, CA 91316

(View Google Map)

CONTACT:

818-539-7383

evamohebanlcsw@gmail.com

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