Please make sure that you have read THE FINE PRINT to its entirety, so that there are no misunderstandings between us.

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I require this form to be filled out completely and truthfully.  I will NOT accept provider references, p411 okays or reviews as a sole basis of screening.   This is the main source of verification when it comes to my safety.  No exceptions.

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I will NEVER CONTACT any information, as I find that invasive and extremely indiscreet.  I use my own birds eye approach to view and back out.  Then DELETE.