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Blooming Butterflies Therapy LLC
Intake Form
Your Privacy Matters
At Blooming Butterflies Therapy LLC, we take the protection of your family's information very seriously. Your privacy is important to us. Any personal, medical, or behavioral health information you provide in this form is protected under the Health Insurance Portability and Accountability Act (HIPAA) and will be used solely for the purpose of evaluating your child's/client's needs and coordinating care. Information submitted here is transmitted securely and will only be accessed by authorized clinical and administrative staff involved in your care. We do not sell, share, or disclose your information to third parties except as required for treatment, billing, or as permitted or required by law
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