Intake Process

  1. Free Intake Phone Consult – 224-208-5228
  2. Schedule tentative appointment with intake coordinator
  3. Immediately after phone call, register on secure Patient Portal (within 24 hours) to confirm appointment. Complete the following:
    1. Client profile information
    2. Insurance information with photo attachment
    3. Client Rights Form
    4. Intake Questionnaire
    5. Cancellation Policy
    6. Add credit card to secure your scheduled appt
  4. Complete the Telehealth Consent Form
Forms for printable reference

Client Rights and HIPAA Forms
Credit Card Authorization Form
Couples Intake Questionnaire

LifePoint Therapy