Patient Forms

Taking Steps Together

Lifespan Behavioral Health Services

Welcome to Lifespan Behavioral Health Services (LSBH), a practice established by licensed practitioners from GWPC who believe that mental and emotional health are as important to our overall functioning as physical health.  By utilizing a combination of evidence-based treatment strategies with a personalized approach, we will be “taking steps together” toward recovery and wellness…across the Lifespan.

Thank you for allowing us to share in your care.

Existing Patients

Even if you were with us at GWPC or new to Lifespan Behavioral Health Services, please complete our new paperwork. Our new paperwork is available for download or you can complete all of the new paperwork online.

Complete New Paperwork Online

All of our forms are now available for you to fill out online.  Begin the paperwork by starting with the Patient Registration Form. When you complete the Patient Registration Form you will be prompted to continue to the Authorization of Service and Financial Policies. Once you complete each form and click submit, you will be redirected to the new form.

Download Patient Forms

All of our forms are available for download as a PDF. You can print them out yourself and fill them in and bring to the office.

Patient Registration Form

Authorization of Service and Financial Policies

Informed Consent For Assessment And Treatment

Telehealth Consent

UDS Controlled Substances Agreement

HIPAA Notice of Privacy Practices

HIPAA Compliance Patient Consent Form

Authorization for Disclosure of Protected Health Information

Client Handbook

Patient Information Regarding Credit Card on File Policy

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