This form is for referral/patient inquiries only.
We cannot offer diagnosis, counseling or recommendations online, but an Assessment and Referral Specialist is available 24 hours/7 days a week at 281.404.1001. If you are currently experiencing an emergency, please dial 911 or go to the nearest emergency room.
Do not use this form if you have a medical emergency or urgent problem. Instead, please call 281-404-1001. If you need immediate medical assistance, please contact 911 or seek the nearest Emergency Room.