Forms

Intake Forms - Dr. Spaine, Heather Shy, LPC, Samuel Daily, LPC

We now offer a secure client portal to allow you to complete your new patient paperwork at a time and a place that is convenient for you. When you call to make your first appointment you will be given a link to the portal. Of course, if you have any questions while completing your new patient paperwork, our office staff is always available to answer your questions.

Intake Forms -Sam Daily, LPC

For your convenience, you may schedule a new patient appointment and complete your new patient paperwork with Sam Daily, LPC online, via the secure patient portal below. If you have any questions while filling out your paperwork, please feel free to contact our office at (479) 442-8900.


Portal Users Please Note: In order to allow us to thoroughly review your information prior to your first appointment, we must receive your paperwork via the online portal at least 2 BUSINESS DAYS prior to your first appointment. If we do not receive your paperwork within this timeframe, It may be necessary to reschedule your appointment.