Forms and Links
Prior to your initial visit, you will need to complete all your forms. 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.
All forms must be completed prior to scheduling an appointment.
Should you need to cancel your appointment, please do so 24 hours prior to avoid a late cancellation fee. If you are more than 15 minutes late, you may be charged the cancellation fee AND asked to reschedule. If you must cancel a Monday appointment, please contact the office by the prior Thursday at noon to allow other patients an opportunity to fill the open slot.
If you have any questions, you can call the office at (850) 897-7810.
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 be brought as applicable per the instructions listed next to each item.
HIPAA You may choose to print this for your records only. We do not require a copy
Release of Information
Please bring only if we need to request records from a previous provider.