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Patient Forms

After selecting the appropriate forms, please print and fill out forms PRIOR to your scheduled appointment. Thank You!

Consent to Release & Receive Information

Consent To Treatment

PHI Policy

PHI Acknowledgement

Patient Questionnaire

Telehealth Patient Form

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Service Region

Waterstone Counseling Centers serve New London, New Haven and Middlesex Counties, Connecticut. The medication component of our MAT program requires a regional service area, however, our unique Integrated Psychotherapy services are available to a non-local community through telehealth solutions and our interactive education platform.