Skip to content

832-559-2622

832-699-5001

Get Started Now

About
Find a Therapist
Get Help
Groups & Events
Resources
Locations
- All Locations
- Offices
- Online Therapy
  - Alabama
  - California
  - Florida
  - Illinois
  - Indiana
  - New York
  - Pennsylvania
  - Texas
  - Virginia
  - Washington
Hiring

×

About
Find a Therapist
Specialties
Types of Therapy
Groups & Workshops
Self Tests
Wellness Library
Locations
Hiring
Book An Appointment

Thanks for reaching out.

Our Client Care Coordinator will call you within 24-48 business hours.

In the meantime, please take a moment to fill out this form so we can better help you.

Appointment Information

Please tell us briefly why you are seeking support?(Required)

Preferences in your therapist?(Required)

What are the best times to contact you?

When would you have the ability to come for appointments?(Required)

Weekday Mornings (9-11am)

Weekday Lunch (11-2pm)

Weekday Afternoon (2-5pm)

Weekday Evening (5-8pm)

Weekend (Sat & Sun)

(Greater availability helps us match you better.)

Would you prefer to meet with a therapist in-person or online?(Required)

Prefer in-person only

Prefer online/telehealth

Open to either

Who is the appointment for?(Required)

Please provide your child/children's information below

Please provide your partner's information below

Child Information

Parent or Guardian's Name(Required)

(who is making the appointment)

First Last

Your Childs Name(Required)

First Last

If signing up more than one child, please list all children's first and last name and date of birth.

Does the child/teen live with both parents?(Required)

Yes

No

**Since the child does not live with both parents, please confirm that you can obtain one of the following:

Consent from both parents
Custody paperwork saying the parent bringing the child/teen to counseling can make these decisions without the other parent consenting

I am able to get the required consent listed above.(Required)

Yes

No

Your Partner's Information

Partner's Name(Required)

First Last

Your Partner's Date of Birth(Required)

MM slash DD slash YYYY

Your Partner's Email

Your Contact Information

Your Name(Required)

First Last

Phone(Required)

Date of Birth(Required)

MM slash DD slash YYYY

E-mail(Required)

Enter Email Confirm Email

Address

Street Address City State

Additional Information

Counseling Interest Areas:

ADHD

Anxiety

Career

Child Therapy

Dating & Relationships

Depression

Disordered Eating

EMDR

Family & Parenting

Grief

LGBTQ+

Life Transitions

Postpartum

PTSD & Trauma

Teen Issues

(check all that apply)

How did you hear about us?(Required)

Doctor

Friend

School

Google

Facebook

Instagram

Psychology Today

Other

Who referred you:

Disclosures

Please make sure you understand our insurance and HIPPA policies before submitting this form.

HIPPA Privacy:(Required)

I agree to the privacy policy

Click here to read our full HIPPA privacy policy.

Disclaimer - If you are in crisis or if this is a medical emergency, please call 911 immediately or go to the nearest emergency room. Otherwise, we will respond to your message within 1-2 business days.

Email

This field is for validation purposes and should be left unchanged.

Δ

TAKE THE NEXT STEP

GET OUR NEWSLETTER

First Name*

Email*

Email

This field is for validation purposes and should be left unchanged.

Δ

TAKE A FREE SELF-HELP TEST

The self-tests and quizzes are tools to help you with mental, emotional, career and relationship wellness.

BOOK AN APPOINTMENT

Schedule an appointment with a Counselor. Scheduling is flexible and convenient.

Eddins Counseling emblem

AS FEATURED IN

OUR LOCATIONS

Houston Heights Counseling Center map

HEIGHTS LOCATION

5225 Katy Fwy, Suite 103,
Houston, TX 77007

Houston Montrose counseling center map

MONTROSE LOCATION

1501 Crocker Street, Suite #2,
Houston, TX 77019

Houston Sugar Land counseling center map

SUGAR LAND LOCATION

12930 Dairy Ashford Rd.,
Suite 103, Sugar Land, TX 77478

ONLINE THERAPY AVAILABLE IN

Eddins Counseling emblem

Contact Info

Call Us: 832-559-2622

Text Us: 832-699-5001

© 2010 - 2022, Eddins Counseling Group. All Rights Reserved.
Sitemap XML | Privacy Policy | HIPPA

Quick Links

Groups & Events

Billing/Statements

Make a Referral

Wellness Webinars

Follow Us

Scroll To Top