New Patient Forms
If you are a new patient and have been registered online or by phone and directed to this page, please tap the appropriate button below. Completing this prior to your appointment is required. If you have not yet registered with LifeStance Health, please tap to schedule an appointment or call our office (805) 681-0035.
Request to Release Information
To manage the optional transfer of your protected health information, make your request below.
Form 1: Release Information FROM LifeStance Health
Use this form to authorize the release of your records from LifeStance Health to a third party such as a physician, attorney, school, or for your own records. Also use this form to authorize an individual to schedule appointments on your behalf.
Form 2: Release Information TO LifeStance Health
Use this form to authorize a third party such as another individual or doctor’s office to send copies of your records to your LifeStance Health provider.
Accepting Financial Responsibility
Form 4: Third Party Appointment Scheduling
If you are willing to guarantee payment for the exceptional situation in which a third party is making an appointment for a patient: