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姓名 家庭 住址 联系 方式 年 月 日 时 来访者主诉： ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________咨询要点记录： __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 本次咨询作业与下次咨询计划： ____________________________________________________________________________________________________________________________ 咨询师签名： 年 月 日 心理咨询记录表
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