To request an appointment, join our waiting list or request more detailed information please complete this confidential personal details form so that we can best assist you.
We have been in network with Tricare/Humana Military for 20 years, however, we no longer bill insurance at this practice.
Before your first appointment please submit the appropriate new client forms below:
Conveniently located off 3rd St. 2 blocks north of Beach Blvd., 3 blocks west of the ocean, just east of St Paul's Catholic School.
The office assistant is available 9-5 Monday-Friday for drop off or pick up of packets, waiting room is shared with Story Griffin Consumer Justice Law Firm.
Sessions are scheduled in advance with lunch appointments available. Back to school forms are provided for children when applicable.
Ocean air outdoor area is available in rear.
Complete this form to request further information.
328 2nd Ave., N.
Jacksonville Beach, FL 32250
Nicole Story, EDS, MED, LMFT, LMHC, QS, NCC
Psychotherapist & Clinical Director
Licensed Marriage and Family Therapist
Licensed Mental Health Counselor
Qualified Clinical Supervisor MFT
Qualified Clinical Supervisor MHC
National Board Certified Counselor
Looking for a less expensive option?
Ask about one of our mental health or marriage and family therapy clinical interns!
New Client Forms
Please print and complete the pdf New Client Forms Packet to bring to your first visit or for children please complete and bring the Child New Client Forms Packet & No Subpoena Policy for your child's first visit, or use the Google Forms buttons above to submit online.
All completed forms can be faxed or emailed to Nicole@OceansideFamilyTherapy.com. This email address/electronic communication is transmitted in full compliance with HIPPA's electronic privacy and security policy with a BAA.
For Immigration Hardship Evaluations, please complete the New Client Forms Packet, the Extreme Hardship Report Disclosure and the Immigration Hardship Evaluation Intake Form. You will also need to complete a release of information for your immigration attorney at the time of your evaluation.
For Teletherapy please complete the Teletherapy Consent Form.
For Walk and Talk Therapy please complete the Walk and Talk Therapy Consent Form.
If you are seeking pet assisted therapy for yourself or pet assisted play therapy for your child please also review and complete the Pet Assisted Release Form.
If you are currently involved in a personal/family court case or custody case and are seeking expert assessment or testimony - not treatment, please review our Court Testimony Policy Form. Our practice is designed to provide clinical treatment that is confidential and in the best interest of the client, not to be used to anyone else's advantage in a court of law. In treatment, we adhere to the protection of our patients under the Florida statutes therapist/patient privilege and federal HIPPA law.
Forensic mental health assessments are for clients not in treatment at this practice and are designed only to assist the courts - not treat symptoms. In forensic mental health and family assessments, the patient waives his or her right to confidentiality from the courts. Contact our legal department for more details.
Request to Release Information
All requests to release medical information from this office must be made by the client directly via the form linked below. Be sure to provide the contact information of the physician or entity to whom you wish to forward your information.
Please note that psychotherapy notes are not considered to be part of your accessible information and will not be shared with anyone, as per HIPAA guidelines and therapist/patient privilege.
Cost of copying and mailing information must be paid in advance to any release of information. Allow 1-2 weeks for receipt of signed release and forwarding of any medical information summary as directed.
Resources:
Temperament/Communication Styles - Love Languages Profile Forms
_JPG.jpg)