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New Patients


Welcome to Lansing Psychological Associates.  We are currently accepting new patients for therapy only.
If you are a new patient, and have already called to make an appointment at one of our clinics, please print out and complete the forms listed below. Please note there are different forms for both new adults and new children.

If you are a new adult you have the option to arrive 30 minutes prior to your appointment to complete the paperwork. Please do what is convenient for you, and call (517) 337-6545 if you have any questions.

New Adults: (click on the form to complete online and print or print to complete by hand)
1. Adult Personal Data Sheet
2. Adult Behavioral Questionnaire
3. Follow Up Study
4. Treatment Agreement - Initial all items on page 5 & 6 - Signature of financial responsibility with your SSN
5. Adult History Questionnaire    NOTE: This form is due at the 2nd visit and some parts of this form will need to be completed by hand

Please bring your insurance card and picture ID
Code of Ethics - For your review only.

New Children: (click on the form to complete online and print or print to complete by hand)
In order to best treat your child, please read carefully the instructions below. New child paperwork MUST be completed before the child can be seen at our clinic. Please note, that the Treatment Agreement Form must be signed by both parents prior to the child's appointment, so plan accordingly.

Regarding Custody (If Applicable):
Joint legal custody, is defined as the ability of both parents to make all the major decisions in their children’s lives. When considering a minor child for treatment at LPA, joint legal custody requires both parents signature on the treatment agreement before scheduling the first appointment. Sole legal custody requires court documents stating the custody arrangement. Please be advised of the difference between physical and legal custody. If you need further explanation, please call the office at 517-337-6545 and our support staff would be happy to assist you.

1. Child Personal Data Sheet
2. Child Behavioral Questionnaire
3. Follow Up Study
4. Treatment Agreement - please review bullet points below
5. Child History Questionnaire        NOTE: This form is due at the 2nd visit and some parts of this form will need to be completed by hand

  • Initial all items on page 5 and 6.
  • Both parents/guardians sign with a witness (Witness cannot be the other parent and must be over 18).
  • Signature of financial responsibility with your SSN

Code of Ethics - For your review only.