Jeff Ray, MS, LMHC

Jeff Ray, MS, LMHCJeff Ray, MS, LMHCJeff Ray, MS, LMHC

Jeff Ray, MS, LMHC

Jeff Ray, MS, LMHCJeff Ray, MS, LMHCJeff Ray, MS, LMHC
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Jeff Ray, MS, LMHC

182 North Palafox Street, Pensacola, Florida 32502, United States

Phone: (850) 293-0702 Email: JRayLMHC@ICloud.com Headway: <<https://headway.co/providers/jeffrey-ray?utm_source=pem&utm_medium=direct_link&utm_campaign=44701<<

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Client Contract

  1. Download our client contract forms and return them below before your appointment. 

counseling agreement CMS new (2015_08_26 16_41_21 UTC) (doc)Download
My Telemental Health Informed Consent (docx)Download
Psychosocial Questionnaire Adult (2015_08_26 16_41_21 UTC) (doc)Download
Psychosocial Questionnaire Child-CMS (2015_08_26 16_41_21 UTC) (doc)Download
NDSD2005_AdultScreeningForm_ScoringInstructions (2015_08_26 16_41_21 UTC) (pdf)Download
child-history (2015_08_26 16_41_21 UTC) (pdf)Download
03VanAssesScaleParentInfor (2015_08_26 16_41_21 UTC) (pdf)Download
Child Depression Checklist (2015_08_26 16_41_21 UTC) (doc)Download
Scared Parent-final 1-03 (2015_08_26 16_41_21 UTC) (doc)Download
Scared Child-final 1-03 (2015_08_26 16_41_21 UTC) (doc)Download
Copeland-Symptom-Checklist(Adult.ADHD) (pdf)Download
ces_dc (2015_08_26 16_41_21 UTC) (pdf)Download
04VanAssesScaleTeachInfor (2015_08_26 16_41_21 UTC) (pdf)Download

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