| Group Therapy
Groups on Demand
Register now for Groups On Demand by printing
out this page, completing it, and mailing it in to:
Cris
Karner Psychological Associates
2280 Western Ave.
Guilderland, NY 12084
REGISTRATION FORM |
Name:
|
Address:
|
| Phone:
(day) |
(eve) |
Group(s) interested
in:
|
Method of Payment:
Check ____ Credit Card ____ Insurance
____
Please make checks in the amount of
$280, payable to
Karner Psychological Associates.
Credit card payments can be made by phone. |
For questions regarding insurance reimbursement,
please call (518) 456-5056.
|
