Release of Information Form
Mount Comfort Counseling Services
P. O. Box 3381, Fayetteville AR 72702
4257 N. Gabel Dr, Suite 2B, Fayetteville AR 72703
Glenda Davis, MSC, LMFT, LPC – Therapist
The purpose of this form is to inform you about various contact methods and the restrictions that apply. This will allow us to provide you with the best care while maintaining your privacy.