Wait List

First Name

Last Name

Phone *

Email *

Is it okay for us to leave a voicemail?

Do you have Medicare?

If you are seeking services for a child under 18: Are there other parents or guardians who need to provide consent for your child to obtain therapy services?

Name of doctor or therapist if referred by someone:

Please select a therapist preference below Learn about therapist specialties here.

Therapist Preference

What is your biggest struggle? If requesting for your child, what is their biggest struggle?

What would successful therapy look like? What would be different when therapy is over?

We do not accept insurance. We do accept HSA, FSA, and credit cards. You'll be responsible for the full fee at the time of session. You may be eligible for out of network reimbursement from your insurance company. You can check your out of network benefits by calling the phone number for behavioral health on the back of your insurance card. We're happy to provide a superbill for you to submit to your insurance company for potential reimbursement. What questions do you have about fees or out of network reimbursement?

I consent to receive emails and newsletters from Anxiety Specialists of St. Louis. I may unsubscribe at any time.

Privacy Policy | Terms of Service

100% Secure. Your Email Will be Kept Confidential.
By completing this form you agree to receive electronic mailings and text updates from Anxiety Specialists of St. Louis

Copyright ©2025 All Rights Reserved

100% Secure. Your Email Will be Kept Confidential. By completing this form you agree to receive electronic mailings and text updates from Anxiety Specialists of St. Louis

Copyright ©2025 All Rights Reserved

100% Secure. Your Email Will be Kept Confidential.
By completing this form you agree to receive electronic mailings and text updates from Anxiety Specialists of St. Louis