The Lakewood Group
Policies and Practices to Protect Your Confidential Health Information
This document describes how we protect the privacy of your medical records.
For Your Reference Only
Registration Forms
Print these forms for your first appointment with The Lakewood Group.
These recently became more lengthy due to legal requirements of the HIPPA act. Please accept our apologies.
If you have questions on a section, leave it blank and ask your Doctor or Therapist during the first appointment.
History Form for Children and Adolescents
Print these forms if your Doctor or Therapist asks you to complete the history form for children or adolescents.
History Form for Adults
Print these forms if your Doctor or Therapist asks you to complete the history form for adults.
Medical History Form
Print these forms if you are seeing a Psychiatrist for medications.
Release of Information
Complete this form to allow The Lakewood Group to communicate with a person you choose.
You will need Adobe Acrobat Reader to view and print these forms.
Adobe Acrobat Reader
Click the link to download Adobe Acrobat Reader.
(This is a 15 to 20 minute download with a 56k modem.)
AOL users must have version 8.0 AND Acrobat Reader version 5.0 or newer for the download to work properly.
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