NEW PATIENT?
Please complete your initial appointment paperwork before your session. You can complete this in one of two ways:
Option 1 (Fastest): Use the links on the left below to fill out and submit both of your intake packets online automatically (We need a both the appropriate Profile and corresponding Clinical History packets).
Option 2: Download the appropriate PDF(s) on the right below, fill them out, and email or upload the completed packet back to us.
Along with your forms, please provide a copy of your insurance card(s) and a driver's license or photo ID.
Note: If you prefer, you can also bring your printed paperwork, IDs, and co-pay directly to your scheduled intake appointment.
We look forward to seeing you!
FILL OUT, SIGN, AND SUBMIT BOTH PARTS ONLINE
Valid email required.
New Patient Packet for Adults
New Patient Packet for Children & Adolescents
DOWNLOAD PDFS TO FILL OUT DIGITALLY OR TO PRINT
Return to the office by upload, email, mail, or drop off
CURRENT PATIENT?
If you are a current client and need to submit additional forms, you can access them here:
Option 1 (Fastest): Use the links in the left column to fill out and send your forms automatically.
Option 2: Use the right column to download, print, or fill out the forms manually.
DOWNLOAD PDFS TO FILL OUT DIGITALLY OR TO PRINT
Return to the office by upload, email, mail, or drop off
OFFICE FORMS
Consent for Release of Information
Credit Debit Card HSA Authorization
Practice and Financial Agreement - Adult
Practice and Financial Agreement - Minor
Psychotropic Medications for Minor Authorization
For SPRAVATO® specific forms, contact us at SPRAVATO@lakescenter.com.
For DBT specific forms, click and scroll to the bottom of the DBT page.
For EMDR specific forms, go to the EMDR section of our site.
For Group specific forms, go to the Group section of our site.
HOW TO SUBMIT YOUR COMPLETED FORMS
You can email insurance cards and completed forms to forms@lakescenter.com,
or you can upload them directly to us by clicking the button below.
RESOURCES
Below are some useful resources for our patients. If you are a new patent, feel free to download and bring them to your initial appointment.
Community Resources (pdf)
Mood Chart (pdf)
Mood Disorder Questionnaire (pdf)
NAMI (National Alliance on Mental Illness) Family Resources (pdf)
Tips for Dealing with Anxiety (pdf)
Tips to Maximize Therapy (pdf)
The purpose of psychotherapy (counseling) is to set people free... free from self-defeating symptoms... to experience their possibilities which results in freedom in life.
- Rollo Mary, Psychiatrist and Philosopher
