At LifePointe Counseling and Psychiatry, 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.<\/p>\n
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.<\/p>\n<\/div><\/div><\/div><\/div><\/div>
Financial Forms<\/strong><\/p>\n Whether you plan to use your insurance or pay privately for our services, the forms below serve to clarify our financial policies and procedures.\u00a0 We encourage you to read our Financial Policies document prior to your first visit.\u00a0 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.\u00a0 Missed appointments and late cancellations should be part of your first session discussion.\u00a0 If your provider does not bring it up, be sure and ask.\u00a0 If you are submitting a request for sliding scale fees, please review the Sliding Scale Table document and complete the Financial Disclosure.\u00a0 If you have any further questions, please contact our office at 314-849-2120.<\/p>\n Credit Card Authorization<\/a><\/p>\n Financial Disclosure<\/a><\/p>\n Financial Policies<\/a><\/p>\n Sliding Scale Table<\/a><\/p>\n<\/div><\/div><\/div> New Client Paperwork for Children & Teens:<\/strong><\/p>\n There is an intake form titled \u201cInformed Consent Form for Minors\u201d that we ask each prospective client\u2019s legal guardian(s) to complete prior to the minor\u2019s initial appointment (this is in addition to our standard registration packet, which you can access\u00a0here<\/a>).<\/p>\n You can access this form here: Informed Consent Form for Minors<\/strong><\/a>.<\/p>\n We strongly recommend you fill out this form ahead of time so that you have time to attain the information required for the provider to see your child or teen<\/em><\/strong>.<\/p>\n If you are unable to complete the packet beforehand, please plan to arrive 20 minutes early so that this packet can be completed without interrupting session time. Blank packets will be printed on colored paper and located on clipboards in our office lobby.<\/p>\n<\/div><\/div><\/div> New Client Paperwork<\/strong><\/p>\n 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.<\/p>\n New Client Packet \u2013 Printable<\/a><\/p>\n Client Questionnaire<\/a><\/p>\n Notice Of Privacy Practices & Client Rights<\/a><\/p>\n Life History Questionnaire<\/a> (Lanny McFarland clients)<\/p>\n<\/div><\/div><\/div> Consent Forms<\/strong><\/p>\n 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.<\/p>\n