CBH General Forms: All forms are downloadable and fillable PDF's.- Make a Referral Online
- Patients' Rights & Responsibilities
- CBH Informed Consent (General)
- CBH Notice of Privacy Practices
- Acknowledgement of Receipt of Notice of Privacy Practices (HIPAA)
- Fillable Child/Adolescent Medical/Developmental History Form
- Fillable Adult Medical/Developmental History Form
- Revocation Form
CBH School Forms: To be completed by school personnel.Completed forms can be emailed to cbh@umsl.edu or faxed to CBH at 314-516-4863.
If you have any questions about the documentation you should bring to your appointment, please contact us at 314-516-4357 (314-516-HELP).
If you have any questions about the documentation you should bring to your appointment, please contact us at 314-516-4357 (314-516-HELP).
Contact Information:
CBH at West County
- 12837 Flushing Meadows Dr., Suite 220
- Town and Country, MO 63131
- Phone: 314-516-4357
- 314-516-HELP
- Fax: 314-516-4863
- Clinic Hours
- 8:00 AM - 8:00 PM, Monday - Thursday
- 8:00 AM - 5:00 PM, Friday - Saturday
CBH at UMSL
- One University Blvd.
- 232 Stadler Hall
- St. Louis, MO 63121
- Phone: 314-516-4357
- 314-516-HELP
- Fax: 314-516-4863
- Clinic Hours
- 8:00 AM - 8:00 PM, Monday - Thursday
- 8:00 AM - 5:00 PM, Friday - Saturday