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Reginald Nettles, PhD, CGP
410 290-7999
6217 Ironwood Way
Columbia, Maryland 21045
United States

[email protected]

If you're a new client, please complete the following form and bring it to your first therapy session.

  • Client Psychotherapy Intake Form

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), a form to authorize release of protected health information (PHI) will be provided at your first or later sessions as needed:


Client Psychotherapy Intake Form  


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