• This form is for New Patient appointments only. For current patients, please visit https://lsbhtherapy.com/contact-us/ for locations and contact information.

    After you submit this form, a member of our team will contact you with information on how to complete the registration in our Patient Portal. Once the necessary documents are complete, we will schedule the first available appointment with one of our providers. Thank you for reaching out to us and we welcome you to our practice.

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  • If your insurance is not listed in our drop down menu, then we do not participate with your carrier and you will need to pay our self pay rates listed in our Fees & Insurance menu.
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  • Student's Name
  • This field is for validation purposes and should be left unchanged.