Paperwork For:

Shari Adams, MA, LMHC

Please print the paperwork marked * and bring it with you to your first appointment. The other paperwork listed will need to brought as applicable per the instructions listed next to each item.

Problem Inventory *

Informed Consent to Treat *

HIPAA - You may choose to print this for your records only. We do not require a copy for your file. 

Release of Information- please bring only if we need to request records from a previous provider.

Paperwork For:

Kathlyn C. White, MA, LMHC, LMFT, QS

Please print the paperwork marked * and bring it with you to your first appointment. The other paperwork listed will need to brought as applicable per the instructions listed next to each item.

Problem Inventory *

Informed Consent to Treat *

HIPAA you may choose to print this for your records. We do not require a copy. 

Release of Information please bring only if we need to request records from a previous provider.

During your initial visit we will need to collect some information. For your convenience the forms listed here can be printed and filled out  prior to your scheduled appointment. There is also a patient portal available to fill out the forms electronically. If you are interested in this option please call the office at the number listed below.

If you are unable to fill out the forms prior to your appointment please arrive 20 minutes early to complete them. Should you need to cancel your appointment please do so 24 hours prior to avoid the $50.00 late cancellation fee.

If you have any questions you can call the office at (850) 897-7810.

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