Patient Forms edit
Note: These forms must be printed, completed, and returned to our office at the first appointment! Do NOT email the competed forms back to us. Thank you!
To download, right click and click “Save as.”
- Full Intake Forms – Adult – LPC
- Full Intake Forms – Child- LPC
- Full Intake Form – Adult
- Full Intake Forms – Child
- Full Intake Forms – NT- Adult
- Intake Forms NT- Child
Nota: Estos formularios deben estar impresos, rellenados y devuelto a nuestra oficina! Por favor de no regresar las formas por email. ¡Gracias!
Para descargar, haga clic derecho y haga clic en “Save as”.
- Full Intake Forms – Adult – LPC – Spanish
- Full Intake Forms – Child – LPC – Spanish
- Full Intake Form – Adult – Spanish
- Full Intake Forms – Child – Spanish
- Full Intake Forms – NT – Adult – Spanish
- Intake Forms NT – Child – Spanish
For Physician’s Office Staff – To initiate services at LifeSteps, please complete the following Therapy Request Form.
Should you decide to forward your own script, please include the patients name, DOB, contact name and number, DX and physician signature. We will need latest medical visit notes or pertinent Medical Records.