Play Heals
Therapy for Individuals and Families
Jackie Hurt-Coppola, M.A., M.S., MFT
CA Lic. #MFC52889
Filling out the forms ahead of time saves us valuable face to face time.  Please download and fill out the forms below before the first session if possible.  This will save time in the first session and allow me to have some background information when we meet. Please fill out entire packet for children, all except the Minor Consent for adults.
Intake Packet-Children and Adults
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