Nancy Goodman, LCSW
12157 W. Cedar Dr. Suite 200
Lakewood, CO
80228 303-916-6929 * www.aparentconnection.com
nlbgoodman@gmail.com * License #992896
Client Registration Form
Please be aware that confidentiality cannot be guaranteed when using electronic
Health care providers involved in your care with whom you may like me to be in contact: (I will only contact them with your permission and a signed release of information