Pay Online

Thank you for trusting Saint Louis Counseling. You can make a secure online credit card payment by completing the form below.

A receipt of payment will be emailed to the address provided on this form.

For questions, please contact Intake at (314) 544-3800 or SLC@ccstl.org.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Today's Date*

Client First Name*

Client Last Name*

Location of Service*

Therapist or Program Name

Cardholder Name*

First Last

Email*

Phone*

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Amount Paid*

Credit Card*

Make a secure payment toward your counseling balance.