The Admin Team may request that you complete one or more of these forms. If you have questions, please contact the Admin Team at (636) 442-2612.
The New Client Consent Form is a required step in the New Client Registration process.
The Client Update Form may be requested by the Admin team to update your information and consents.
The HIPAA Consent Update Form authorizes the release of information regarding scheduling and billing.
Your counselor may request that you complete one of the following assessments:
The Adult Self-Rated Symptom Measure.
The Self-Rated Symptom Measure for Minors Age 11–17.
The Parent/Guardian-Rated Symptom Measure for Minors Age 6-17.
Sponsorship of Counseling Services Authorization
If you or your organization would like to sponsor counseling services for others, please complete this form to authorize payments for sessions.
The Sponsorship Authorization for Counseling Services.
These forms are all included in the New Client Forms, but may be requested separately by our Admin staff if updates are needed:
Clients must complete the COVID-19 Waiver & Release form before coming to the office for in-person sessions.
The Release of Information Authorization must be completed before protected health information may be released.