Home
Rates & Insurance
Company
Get Started
About Us
Counselors
FAQ's
Employment
Services
Counseling
Intensives
Groups
Workshops
Resources
Telehealth
Contact Us
Book Online
Legal Document Upload
(optional)
100%
Name of Minor (Client being seen)
First Name
Last Name
Name of Parent/Legal Guardian
First Name
Last Name
Phone
Email
Name of Therapist
Appointment Date
Appointment Time
Message & Upload
Message
Upload File
Max file size 10MB.
Uploading...
fileuploaded.jpg
Upload failed. Max size for files is 10 MB.
File Upload
If you need to upload more than one file, either combine them into one pdf and upload above, or email them to
nancy@christiancounselinghouston.com.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Back
Next
Katy
(281) 398-0022
Sugar Land
(281) 277-8811