Financial Forms

Whether you plan to use your insurance or pay privately for our mental health services, the forms below will help clarify our financial policies and procedures.  We encourage you to read our "AOCC Financial Policies" prior to your first visit.  If you are submitting a request for sliding scale fees, please review and complete the Financial Disclosure Form and Sliding Scale Chart.  Please note that not all of our health care providers provide sliding scale rates.  If you have any questions, please contact our office at 314-849-2120. You may click on any of the blue buttons below to download the corresponding document in PDF format.

Please click on any of the blue buttons listed below


to download the corresponding document in PDF format.

Got Questions?
Please don't hesitate to contact us at 314-849-2120.