Andy Anderson, M.A., LPC, KPMT
Parenting and Child Conduct Counseling
(636) 674-9583
New Client Forms
"Whether you're a new or current client, we've made it easy for you to complete any necessary paperwork or assessments from the comfort of your own home. Our online resources are designed to help you fulfill any requirements quickly and conveniently. If you have any questions or concerns about these requirements, please don't hesitate to contact us directly. We're here to help."
Informed Consent
Our Informed Consent provides essential information to clients, parents, or legal guardians about their rights and responsibilities in the counseling relationship. It outlines the counselor's responsibilities regarding confidentiality, record-keeping, diagnosis, and managed mental health care.
The purpose of obtaining written consent is to ensure that clients and their parents or legal guardians fully understand the terms of the counseling relationship and agree to participate in treatment. The document also explains the legal exceptions to confidentiality and the client's right to access their file anytime. You are asked to complete the Informed Consent form by clicking on the button below to acknowledge that you understand and agree to the terms outlined in the document.
The Informed Consent includes two sections. The first section contains a general consent which permits the provider to treat the client. All new clients must sign this section before they can receive treatment.
The second section specifies the terms and conditions of court work, including appearances at court, travel time, depositions, phone calls, and other related work. Clients must only sign this section if they need the provider to perform court work. The fee for court work is $150 per hour and is not reimbursable through insurance.
Authorization to Exchange Information Health-Education
Your counselor might want to talk to another adult who works with your child, like a teacher or a mental health professional, to help them better understand how to treat your child in therapy. If the counselor asks for permission to do this, you can give permission by clicking the button below.
Intake Forms
When you meet with a counselor for the first time, they commonly ask you to fill out an intake form. This form will typically ask you to provide basic information about yourself, such as your name and contact information, as well as more detailed questions about your personal and family history, mental health history, and any current symptoms or concerns.
The reason for filling out an intake form is to help the counselor get a better understanding before your first session. By reviewing your information, the counselor can focus on your concerns and needs and provide more effective treatment. This can help ensure that your counseling sessions are productive and helpful.
It's essential to be honest and thorough when filling out the intake form, as this will help the counselor better understand your situation and provide more effective treatment. You don't need to be ashamed or embarrassed about any information you provide, as everything you say is confidential. Your counselor won't share any of the information you provide with anyone else without your permission. So, be open and honest with your counselor about your concerns and personal history.
Please complete the intake form that fits the problem. Specifically, for issues related to behavior, individuals should fill out a behavioral intake form appropriate for their age group. If the problem is not related to behavior, a different intake form that is not focused on behavior should be completed.
It is essential to choose the correct form to ensure that the counselor can provide the most effective assistance.
Non-Behavioral Intake