Self Pay Form

Please contact us if you have any issues!

kindred@CounselingwithAffinity.com
(870) 324-5122 | 573-840-0440

Monday thru Friday 9-5 pm

 

Self-pay option is based on a first-come, first-serve basis. We have limited availability, so please be patient as we work down our list. You will be updated on your spot on the list biweekly. We must have a payment option on file for you before your first appointment. Thank you!