(609) 482-3701
(609) 482-3701
info@lifebacknj.com
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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