If you are a new client, please:
1. Print and Complete, or Complete Online, the New Client Information Packet
2. Sign and Date all appropriate pages
3. Printable forms can be emailed to [email protected] or you may FAX the forms to (850) 243-2702
Remember: Attach a copy of your insurance card and a photo ID to your paperwork.
If you have any questions, do not hesitate to call us at (850) 243-8086.
Printable Forms Links:
- New Patient Information Packet (Includes: Personal and Insurance Information Sheets, Financial Policy, Confidential Information Policy, and the Notice of Privacy Practices Information Sheet)
- Credit Card on File Form and Informed Consent for Telehealth
- Completed Forms may be sent by email to: [email protected]
Digital Online Forms Links:
Seeking to coordinate care with another provider?
1. Complete Release of Information Form - to authorize release of assessment and/or psychotherapy information.
2. Printable: Release of Information Form
3. Digital Online: Below
4. For Identity Verification, our staff may request that you attach a copy of a government issued, signed photo ID, along with contact telephone number.
5. Return completed forms and identification information by mail, email or FAX (850-243-2702).
Seeking a personal copy of your records or the records of a minor?
1. First: Discuss this request directly with your therapist.
2. Privacy: Due to the highly private nature of Mental Health Records, a Summary of Treatment typically is provided when records are requested.
3. Cost: As the cost of producing a summary or writing a letter, copying and mailing records, or faxing records is not covered by most insurance companies and is considered a "Special Service", please consult with the Staff at Turning Point to obtain an estimate of your charges for such non-covered services.
4. Special Services: Some insurance companies require you to sign a special form when paying for non-covered services.
5. See our Rates & Insurance page for more information regarding Special Services.
6. Policies for Release of Records can be found by clicking here.
Release of Information Form (Printable Form)
Release of Information Form (Complete Online - For Dr. Miller)
Release of information Form (Complete Online - For Dr. Chandler)
Release of Information Form (Complete Online - For Dr. Tucker)
Note: To download Adobe Acrobat Reader for free, click here