Carri Riemer, Your Trusted Therapist
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Forms

Patient Info
Electronic Communication Release and Notice of Privacy Practices
Insurance Information
Credit Card Authorization
Private Pay Agreement

Please email these forms to me at carri.riemer@gmail.com

Contact Carri

(248) 325-8234

carri.riemer@gmail.com

5600 W. Maple Road,
Suite B-213,
West Bloomfield, MI 48322

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