Registration | My Vxw Site T8x1ru

Registration for Peggy Lidstrom LCSW-SAP

PEGGY, I WANT A VIRTUAL APPOINTMENT WITH YOU ON AND I WILL HAVE THE $175 TO START

I WILL BE ABLE TO PAY YOU WITH

ALL INTERVIEWS WILL BE HELD ON

My First name is

My Last name is

Number

My cell phone number is

Last 4 of my socials are

My CDL number is

My phone is an

iPhone

Android

My address is:

My Birth date is:

Month

Day

Year

My Age:

My Marital Status:

My Email:

The date I took my drug test:

My Test Result:

Type of test that I took:

The above information is true to the best of my knowledge. I understand that I am financially responsible for payment to Peggy Lidstrom SAP for the complete Return to Duty process.

My fee is 350.00: $175 for the first session and $175.00 wrap-up session

Budget $130 for a drug counselor. Total RTD should cost around 480.00.

You pay in three steps:

1. 175 with Peggy- initial evaluation

2. 130 for two sessions with the counselor (This rate might vary according to treatment or education)

3. 175 to finish up with Peggy

You must be able to pass a drug screen I recommend you order from AMAZON—- PRIME SCREEN Marijuana (THC) Multi-Level Urine Drug Test- costs 15.00 for five tests You need to have the 15 ng. cut off –

Registration for Peggy Lidstrom LCSW-SAP

Appointments within 24 hrs.