Appointments


Our appointment desk is open between the hours of 9:00 A.M. and 5:00 P.M., Monday through Friday.

If you are unable to keep your appointment, please call at least 24 hours in advance to cancel or reschedule. This will allow us to allocate that time to another patient. For non-cancelled (no show) appointments, and for late cancellations (less than 24 hours notice), you will be charged the full rate.

Please inform the secretary of any changes in home or business telephone numbers, address, marital status, or in insurance coverage which may have occurred since your last visit.


 

Prescriptions


Policy

 


 

Forms


Please fill out these forms electronically and submit via email.

 

Patient Information Form

Patient Permission To Disclose Form

Treatment Agreement Form

Consent to Release Information to Physician Form

Directions

Privacy Notice

Personal Medication Form


If you are seeing Dr. Lubberstedt for the first time, please fill out:

Starting in June Psychiatric Services, PC is implementing a new policy that all patients under the age of nineteen must have a credit card on file as all copayments, deductibles and co­insurance is due at the time of service. A receipt will be mailed to the person whose name is on the credit card. We are doing this as a convenience for the patient so they are not asked for payment on the day of the appointment.

We do accept Visa, MasterCard, Discover or American Express.

Thank you for your understanding and cooperation regarding this policy.

Pre-Registration Information

 

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Please download the Patient Information Form and the Personal Medication Form and fill it out electronically then submit it via email. The Pre-Registration form for Dr. Lubberstedt should be filled out in the same manner.

 

 

Form Assistance


If you are having trouble getting the forms to work here are a few tips to help:

 - Make sure you have Adobe Acrobat installed on your computer and it is up to date.

Adobe Acrobat Reader.pngIt can be downloaded at http://www.adobe.com/products/acrobat/readstep.html


 - Make sure you have downloaded the form to your computer first. You will not be able to fill them out through your web browser.

 - Once you are done filling them out you can click the submit button. It will open an email that you can send on to us.

 - If you have the form filled out but it will not submit then you can just save the file, then email it straight to us as well.

 - If you have any issues please let us know.

Billing


In order to keep billing costs to a minimum, patients are required to pay any co-pays, deductibles and coinsurance at the time of service. Mastercard, Visa, and Discover are accepted. Any patient who wishes to discuss fees is encouraged to do so with a patient representative or their doctor.

Starting in June Psychiatric Services, PC is implementing a new policy that all patients under the age of nineteen must have a credit card on file as all copayments, deductibles and co­insurance is due at the time of service. A receipt will be mailed to the person whose name is on the credit card. We are doing this as a convenience for the patient so they are not asked for payment on the day of the appointment.

We do accept Visa, MasterCard, Discover or American Express.

Thank you for your understanding and cooperation regarding this policy.

We are providers for several managed health care plans and insurance programs. Please inform us at the time of your visit which plan you are enrolled in. Payment is made directly to your physician.

When patients have non-managed health care plans and benefits are payable, the insurance contract is between the patient and the insurance company, therefore, prompt payment remains the personal responsibility of the patient.

Accounts are considered delinquent 60 days following the date of service. Any returned check will subject you to a return fee charge.

American_Express_card_logo.png discover-card-logo-png.png master_card_logo.jpg visa_logo.jpg  Debit Cards Accepted

Phone: 402-399-9305
Fax: 402-397-3191