Appointment Form

Appointment Form

To initiate service, please complete the following form. A representative will call within one business day to confirm the request. If you are able to come into our office, an appointment will be scheduled at that time. If you are in need of home or school based service and are enrolled in the Medicaid program, a clinician will call to schedule the appointment within three business days.

Your answers to the following questions are kept in the strictest confidence and will be used to assign a clinician with experience in working with your specific needs.

Client Data:


Reliable Clinicians

Professionals with years of experience

You can Find Us Our Location

6315 Gulfton St., Suite 100 Houston, Texas 77081.

Contact Us : 713-457-4372

You Can Contact Us Anytime