Shawna Kemp, LCSW
(904) 493-6116
P.O. Box 8904
Jacksonville, FL 32239
kempcounseling@yahoo.com
HELPFUL FORMS

If you're a new client, please complete the following forms and bring them to your first session.

  • Client Intake Form
  • Limits of Confidentiality/Cancellation Policy Form

 

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form:

  • Consent to Release Information Form

Client Intake Form
Confidentiality and Cancellation Policy
Disclosure Authorization

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