Islands Counseling, LLC

Jessica Campell

Marcia C. Barksdale, LPC

Marcia's Intake Forms

Janell Harvey, LPC

Janell's Intake Forms

Jessica Campbell, MA

Jessica's Intake Forms

Women's Issues Resources

Eating Disorder Resources

Hotline #s and Resources

Nutritional Eating

Directions

Please read all of the paperwork on this page before the first appointment.  Choose one of the options below to complete the paperwork required.

Option 1: (Preferred) Please fill out the Client Intake Form and the Adult OR Adolescent Form online, save as a document on the computer and email to Jessica at jcampbell@islandscounseling.com.  This is the preferred option.  Please read the other paperwork.  Please sign and bring in  ONLY the Confirmation Page.


Option 2:  If the forms are not completed online only the three pages listed below need to be printed and brought to the office.  First read all of the information on this page and then, fill out the Client Intake Form and the Adult or Adolescent Information Form.  These and the signed Confirmation page should be brought in on the first appointment.



Please bring your insurance card with you to the office so that we may obtain a copy for our records.  Thank you. 


ADULT INFORMATION FORMADOLESCENT INFORMATION FORM
CANCELLATION POLICYPRACTICES AND PROCEDURES
HIPPA PRIVACY NOTICECONNFIRMATION PAGE
   
 
















Islands Counseling •  2953 Bienville Boulevard • Suite 145
  Ocean Springs • MS • 39564  • 228-324-5767