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Patient Forms

In order to save time, you may print out and fill in your patient forms prior to your appointment.  During your initial visit, we will need your patient registration information as well as your medical history.


LifeCare files insurance claims on your behalf. All of our therapists are Licensed Professional Counselors and are able to accept medical insurance. Refer to your policy for a summary of mental health / therapy benefits as well as any limitations such as frequency of visits.


Forms for Download:


Medical History


Fee Application


Patient Registration


Consent Form for April Miller


Consent Form for Jerry Lankford


Consent Form for Marilyn Harding


Consent Form for William Venable


Consent Form for Bethann Detwiler


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1215 Jones Franklin Rd, Suite 201, Raleigh, NC 27606     Telephone: (919) 851-1527

Serving Raleigh, Cary, Durham and surrounding areas.

Life as it was meant to be