Download your initial appointment paperwork here.
Please email or upload the completed packet (including the financial agreement), with your insurance card, and driver's license or ID before your scheduled intake appointment. You can also bring everything with you to your appointment, along with the means to pay your co-pay.
New Patient Forms for Adults (pdf)
New Patient Forms for Children and Adolescents (pdf)
Here are some additional forms you might need at a later date.
Credit & Debit Card Authorization Form (pdf)
Release of Information Form (pdf)
Privacy Practices (pdf)
For SPRAVATO® specific forms, contact us at SPRAVATO@lakescenter.com.
For DBT specific forms, go to the DBT section of our site.
HOW TO SUBMIT YOUR COMPLETED FORMS
You can email insurance cards and completed forms to firstname.lastname@example.org,
or you can upload them directly to us by clicking the button below.
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)