Daniel I. Schacht, LICSW | Natick, MA | 01760

Therapy for Individuals, Couples, Adolescents & Families

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774-292-9011
20 Main St. Natick, MA 01760
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Client Forms

If you’re a new client, please complete the following forms and bring them to your first therapy session.

Client Intake

Client Contact Information Sheet

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

Authorization for Release of Information

Daniel I. Schacht, LICSW


774-292-9011
info@danielschachtmsw.com
20 Main St.
Natick, MA 01760

Contact Me

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