• (609) 482-3701
  • (609) 482-3701
  • info@lifebacknj.com
LifeBack - Get Yours
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Menu
  • Home
  • About Us
  • Our Services
    • Mental and Behavioral Health
    • Psychiatric Services
    • Substance Use and Addiction Recovery
    • Children and Adolescent Services
    • Special Services
    • Virtual Group Sessions
  • For Patients
    • Intake Form
    • TeleHealth Links
    • Records Request
    • Health Links
    • Confidentiality and HIPAA
    • Patient Survey
  • FAQs
  • Reviews
  • Contact Us

Our Services

Health Forms & Links

General Links

Annual Facesheet
Treatment Plan Signature
Treatment Effectiveness Screening Tool (Scheduled Forms)
Safety Plan/Contract
Suboxone Treatment Compliance (Outside Therapist Verification)
Upload and Sign A Document
Primary Care Release NJ
Primary Care Release PA
PA - MH Patient Bill of Rights
PA – SUD 255.5 Insurance Consent ROI
PA – SUD 255.5 Lab Screen Consent ROI – Lab Corp
PA – SUD 255.5 Lab Screen Consent ROI – QUEST

General Documents

Mental Health Advanced Directives For Pennsylvanians
Mental Health Pt Rights and Grievance 2019
Rapid HIV Testing Sites in Mercer County
PA Psych Advance Directives
Summer Heat and Sun Risks - Updated

Intake Links

Intake - Patient Rights
Intake NJ - MH Patient Rights and Grievance Information
Intake Form (Pre-Admit)
Intake - Treatment Effectiveness Screening Tool
Intake - Overall Health Wellness Questionnaire
Intake - Acknowledgement New Patient Information
Intake - Consent to Treatment
Intake - Financial Policy
Intake - HIPAA Notice of Privacy Practices/Receipt
PA - MH Patient Bill of Rights
NJ – Release of Information

Call today for the very best in compassionate, professional family behavioral health care.

(609) 482-3701
LifeBack - Get Yours

A new day is dawning, LifeBack will help you get there. Right now, you have an opportunity to take the first step in becoming the person you’ve always wanted to be. Call today to take the first step: (609)482-3701.

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Services

  • Psychiatric Services
  • Addiction & Recovery
  • Mental & Behavioral Health
  • Children & Adolescent Services
  • Special Services

New Jersey

  • 4 Princess Road
    Suite 206
    Lawrenceville, NJ 08648
  • (609) 482-3701
  • fax: (609) 482-3702

    Email
  • info@lifebacknj.com

Pennsylvania

  • 10 South Clinton Street
    Suite 100
    Doylestown, PA 18901
  • (267) 935 9925

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