Patient Resources
Patient Forms
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Office Forms
Here at Lifegate Healthcare Services, we are committed to working closely with you and your loved ones to gather the necessary information and history to determine what level of care may be appropriate. Our admissions specialists are available to answer any questions you or your loved one may have regarding the treatment process.
Patient Registration Forms
If you are a new patient to our practice, please take a moment to print and complete the required form(s) directed by our admissions specialist. If completing these patient forms in advance, please bring the completed form(s) with you to the office.
To download the form(s) and information you need, simply click the links below. You can complete these patient forms in advance, or complete the copy provided by one of our Patient Service Representatives at check-in.
If you are a new patient to our practice, please take a moment to print and complete the required form(s) directed by our admissions specialist. Please bring the completed form(s) with you to the office.
The following forms may be downloaded in PDF format.
*Please note that these forms may not be the appropriate forms for all patients in all circumstances.
New Patient Forms
Notice of Privacy Practices
Consent to Treatment and Release of Information
Client Bill of Rights
Client Rights and Responsibilities
Informed Consent to SUD Treatment
Non-Discrimination Notice
Existing Patient Forms
Confidentiality Statement — Telemedicine
Office Policies
Our Strategic Plan
Person Centered Planning
Standard Procedure for Client to File Grievance
SUD Program Orientation
