Counseling Appointment Request Form

Please complete this form to request a counseling appointment with an ETCG therapist. The information on this form will be used to assign you to an available counselor. Each counselor at East Texas Counseling Group schedules appointments directly with their clients. While we do our very best to assign you to a counselor based on your needs, we are not always able to accommodate every scheduling or financial need.

A counselor will reach out to you within 48-72 business hours after completing this request form.

Financial Preference: Please Select at least TWO options in the following multiple choice question box below:

In an effort to keep our services accessible and provide counseling in a timely manner, ETCG offers multiple rate options. Please be aware the counselors who bill in-network with some private insurance may not be available to accept new clients at this time. For this reason, please select more than one of the following preferences. If you have private insurance, you may be able to receive a reimbursement directly from your insurance for seeing an out-of-network counselor. We also offer low fee counseling through our internship program. For additional information on counselors and rates, please follow the links below or visit our FAQ page.