Clients Currently Utilizing Client Portal

Please indicate your preference regarding the portals:

Yes, I would like to continue to utilize the portal and would like for all of the information on my current portal to be transferred to my new portal.

Yes, I would like to continue to utilize the portal but do not transfer any data from the current portal.

No, I would no longer care to utilize the portal.

If you checked yes above, please provide us with the email address you would like to use to access your new portal:

Please provide us with the client name:

Should you have any questions about these portals before completing this form, please feel free to call us at (850) 435-7400.