Forms

Forms.jpgAt LifePointe Counseling, you will need to fill out a variety of forms.  Some of these forms are mandatory, such as the registration. Other forms are optional and/or related to specific issues you may encounter.

For your convenience, we have organized these forms by topic with a designation as to whether they are mandatory or optional.  Most clients prefer to print these documents at home and bring the completed forms with them on their first visit.  However, we also have hard copies available upon your request in our office.

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New Client Paperwork

New client paperwork is mandatory.  Legally we have to provide you with our HIPAA, Notice of Policy Privacy, and Client Rights documents.  Or, if you prefer, you may come to your appointment 15-20 minutes early and fill out the new client registration paperwork in our office.

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Financial Forms 

Whether you plan to use your insurance or pay privately for our services, the forms below serve to clarify our financial policies and procedures.  We encourage you to read our Financial Policies document prior to your first visit.  If you will be paying for our services by credit/debit/HSA card, it will be required to have one of these cards on file with our office. This simplifies paying your co-pay or if there is a charge for a missed appointment or late cancellation.  Missed appointments and late cancellations should be part of your first session discussion.  If your provider does not bring it up, be sure and ask.  If you are submitting a request for sliding scale fees, please review the Sliding Scale Table document and complete the Financial Disclosure.  If you have any further questions, please contact our office at 314-849-2120.

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Consent Forms

Consent forms are mandatory to fill out if you desire your provider to legally coordinate care with other health care providers, such as your general physician or previous mental health providers.

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Marketing Documents