FORMS

If advised by Jessie, please fill out and sign these 4 forms
And email them back to her. Thank you!

Download

Informed Consent

Download

Informed Consent for Telehealth

Download

rRelease of   Information

Download

Rights & 
Responsibilities

For CCS and CCF clients

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Click below for the Referral Form

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    CONTACT ME

    Please call me at 608-347-1432 and leave a detailed message and a good time for me to return your call. 

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    I begin with all clients over the phone with a “needs assessment.” During this call, I learn more about your needs and intended outcomes for services.

     

    Rate Breakdown:

    • The needs assessment by phone takes around 30 minutes and is free of charge. 

    • Rates for all services is dependent upon the scope of work requested.

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    You can pay via cash, check, or by clicking the "donate" button below (which allows you to pay with PayPal, or a credit/debit card.)

      Contact Information. 

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     Email: jessie@collective-voices.com 

      Phone: 608-347-1432   

     

    I can travel to your location anywhere 
    in the States or abroad.

     

    Mailing address:
    1121 N. Johns St. 

     P.O. Box 243 

     Dodgeville, WI 53533 

    Thank you 
    for submitting!

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