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LifeStream Patient Information

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.

Download Packet (1.8MB)
Download Packet (Spanish)

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

Community Resources

  • National Council for Community Behavioral Healthcare The mission of the National Council for Community Behavioral Healthcare is to champion opportunities that advance its members ability to deliver proactive holistic healthcare services.  The National Council for Community Behavioral Healthcare and its members are committed to creating and sustaining healthy and secure communities, achieved through a system that holds the needs of consumers paramount, regardless of their ability to pay.  Vital to this commitment is a network of organizations and advocates promoting services of unparalleled value.
  • National Alliance on Mental Illness From its inception in 1979, NAMI has been dedicated to improving the lives of individuals and families affected by mental illness.
  • Mental Health America A primary goal of Mental Health America is to educate the general public about the realities of mental health and mental illness.
  • Early Learning Coalition of Lake County The Early Learning Coalition of Lake is a non-profit organization established in 1999 when the State of Florida passed legislation to create local school readiness coalitions for the purpose of enhancing children’s chances of achieving future educational success and becoming productive members of society.
  • Safe Climate Coalition of Lake County Promoting a healthy community climate, free of violence and substance abuse.  Safe Climate Coalition of Lake County collaborates with community stakeholders to maximize resources and provide opportunities for children and families to be self-sufficient, productive contributors in Lake County and society.
  • United Way of Lake and Sumter County United Way strives to identify the greatest needs in our community and apply resources to meet the needs.
  • Mid Florida Homeless Coalition The mission of the Mid-Florida Homeless Coalition is to promote partnerships that will reduce and prevent homelessness in Citrus, Hernando, Lake and Sumter Counties.
  • Homeless Services Network of Central Florida HSNCFL is lead agency for the HUD Homeless Continuum of Care for Osceola, Seminole and Orange Counties
  • Lake County Children’s Services Council The Lake Co CSC’s mission is to improve our quality of life in Lake County by providing coordination and funding for prevention and intervention programs for children, youth and families through collaborative, community-based services.  Click the following link to access the CSC Service Provider Directory.
  • Lake County Community Resource Guide The Lake County Community Resource Guide is a database of resources available to people in our community.
  • Lake County Shared Services Network The Shared Services Network way of work helps a community meet the multiple education, health, and social service needs of children in a collaborative way.
  • Genoa, a QoL Healthcare Genoa is an integrated provider of specialized and essential pharmacy services to individuals with mental illness and addictions and those involved in their care. LifeStream Behavioral Center utilizes a Genoa pharmacy site. The pharmacy can be found inside the LifeStream facility located at 215 N 3rd Street Leesburg, FL 34748.

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.

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