New Consumer Registration Packet
If you have an appointment scheduled with one of our Physicians or Counselors, please click the link below to print your registration packet. Once you have the forms printed, please complete each form using black or blue ink. Don’t sign the forms, you will be asked to do that when you meet with the staff at the program. Please be sure to bring the completed paperwork, picture ID, insurance information, or proof of income if no insurance, and co-pay to the first appointment. Please arrive 15 minutes prior to your appointment time to process your paperwork.
Fees for Services
- Sliding fee scale available for individuals who qualify
- Medicare and Medicaid accepted
- Most insurances accepted (call for verification)
- Payment is expected when services are rendered
ADA Policy
NOTICE Under The Americans with Disabilities Act
LifeStream is committed to providing equal access to all persons with disabilities, including LifeStream consumers, potential consumers, companions and others.
To ensure effective communication, LifeStream provides qualified readers, qualified sign language and oral interpreters and other auxiliary aids and services, free of charge, for consumers, potential consumers, their companions and other individuals who are blind, have low visions, and/or are deaf or hard of hearing.
To request auxiliary aids or services, please contact (Tim Camp, QI/RM Director, (352)315-7511, Tcamp@lsbc.net).
The Americans with Disabilities Act (ADA) prohibits discrimination against people with disabilities. Pursuant to Title III of the ADA, persons who are blind, have low vision, and/or are deaf or hard of hearing have the right to request auxiliary aids and services to ensure effective communication.
For more information about the ADA, call the U.S. Department of Justice’s toll-free ADA Information Line at 800-514-0301 (voice) or 800-514-0383 (TTY) or visit the ADA Home Page at www.ada.gov.