Saint Louis Counseling Pre-Registration Forms

For your convenience, our preregistration forms can be filled out electronically from your computer and returned per the intake specialist’s instructions.

It is important to note that in order to save the information that you complete on these forms, you will need to fill out the forms in Adobe Reader and save them
. Other Acrobat programs will not save your information. Download the free Adobe Reader.

IF YOU USE CHROME or CHROMEBOOKS, your work will not be saved after filling out the forms. Follow these simple steps to work around the Chrome/PDF compatibility issue:

1. Right-click the pdf link
2. Save it to your computer
3. Open Adobe Reader
4. Use File > Open to open the form.
5. Complete the form(s).
6. Save your work on your computer.

Thank you for completing the following forms and supplying a copy of your insurance card before your first appointment. We look forward to serving you!

Pre-Registration Forms: ADULTS

Please make a copy of the front and the back of your INSURANCE CARD and return the images with the following forms:

Basic Information and Agreement (BIAS) Form

Telehealth Informed Consent Form

Consentimiento informado de Telesalud

Consent to Treatment Form

Telehealth Informed Consent Form

Acknowledgement of Privacy

No Show-Late Cancellation Policy

Intake Forms-Adult


Pre-Registration Forms: CHILDREN and ADOLESCENTS

Please make a copy of the front and the back of your INSURANCE CARD and return the images with the following forms:

Basic Information and Agreement (BIAS) Form

Consent to Treatment Form

Telehealth Informed Consent Form

Consentimiento informado de Telesalud

Acknowledgement of Privacy

No Show-Late Cancellation Policy

Intake Forms-Child and Adolescent


Call Us at

314-544-3800 or
Request an Appointment

Please submit your information in the form below, and we will contact you soon to schedule an appointment. Thank you for your interest in
Saint Louis Counseling.

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