Legal & Intake Documents
When starting your journey with LifeStar Salt Lake, you'll be asked to fill out a few forms prior to receiving our services. You can print these out at home and come with them filled out, or get them from us in-person at the office.
Beginning Packet
This is the basic starting paperwork that everyone needs to read and fill out:
- Client Registration Form: Download PDF
- Client Payment Form: Download PDF
- COVID - Consent for Treatment Form: Download PDF
- Professional Disclosure and Informed Consent Form: Download PDF
- HIPAA Notice of Privacy Practices: Download PDF
Advanced Documentation
Depending on your work with LifeStar Salt Lake, you may need to fill out these additional forms:
- Third Party Information Letter: Download PDF
- Third Party Payment Authorization Form: Download PDF
- Release and Exchange of Confidential Health Information: Download PDF