Counseling Clinic Form

Please fill out the form below in order for our therapists to ensure you are eligible for our counseling clinic's sliding scale.

Change is possible. Things can get better.

We can help.

If you have any questions, please call us at 512-677-5366 for immediate assistance.

Sign up for our Newsletter to Receive News and Updates

Please enter your name.
Please enter a valid email address.
Something went wrong. Please check your entries and try again.


Austin, TX

Scroll to Top