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Please read the below document carefully, in its entirety. Your agreement to the following terms and conditions is required for you/your child to receive professional services from me. If you do not agree, I will be glad to give you referrals to other providers.

Separated/Divorced Parents Agreement

I understand that Dr. Karin Varblow, MD, will be treating our child/children for the purpose of medication management and psychoeducation.


We understand this evaluation/treatment shall not be used for a current or subsequence legal custody dispute in court.

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