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Each packet is made up of the forms listed below.  You can click on each button to download the individual PDF of the form to review at your leisure.

Because our services are just like a traditional office visit, we do need our New Client Forms completed and confirmed from your email before we can begin services.  You can also access the full forms on this page to review and read further if needed.

For those who do NOT have access to an email address to complete our New Client Forms, you can also do the following:

1. Download the PDF of our New Client Forms or Follow-Up / Returning Client Forms.

2. Complete and sign each page.

3. Fax to 817-405-3364 along with a copy of your Photo Identification.

4. Call us at 817-851-2042 to ensure receipt; let's get you scheduled!

FAQ: How are Services covered?

We accept nearly every major Commercial Insurance, Medicare, Medicaid, CHIP, and managed Medicaid plans:

  • Aetna (PPO, HMO, EPO, Medicaid & CHIP)

  • Ambetter Marketplace Plans

  • Amerigroup (Medicaid & CHIP)

  • Blue Cross Blue Shield of Texas

  • Baylor Scott&White Health Plan

  • CookChildren's Health Plan (Medicaid & CHIP)

  • Cigna (PPO, HMO, EPO, Medicaid & CHIP)

  • "Foster Medicaid" / Superior Health / Cenpatico

  • Humana / LifeSync

  • Magellan

  • Medicaid

  • Medicare (including most managed plans)

  • Molina Healthcare

  • Parkland Health Plan (Medicaid & CHIP)

  • Tricare

  • United Healthcare / United Behavioral Health / Optum

  • Value Options

  • and more!

No insurance? No problem.

  • For those that have no coverage, the first School-Based telehealth visit is complementary.

  • Those wanting to continue services can complete the Financial Assistance Plan to qualify for reduced fee services based on income / Federal Poverty Limits.

Additional Insurance Questions?

FAQ: Can we complete Telehealth in home?

Absolutely.  You can use any of the following computers or devices with camera and microphone:

 

 

STEP 1:  Paperwork and Scheduling.

  • Complete the New Client Forms AND Returning / Follow Up Client Forms.

  • Confirm BOTH documents from your email.

  • Then call our office at 817-851-2042 to schedule a time that works for you. 

  • You will be given the "Room Name" and/or PIN to access the Therapist you will be scheduled with.

STEP 2:  Click the "START YOUR VISIT" Button at the time of your scheduled appointment.

STEP 3:  Type in your name and Check In!

STEP 4:  Allow your browser to use your webcam and microphone.

STEP 5:  Your Therapist will start your visit.

 

FAQ: Who are your Therapeutic Professionals?

Licensed Clinical Social Workers

Licensed Master Social Workers under Clinical Supervision

Graduate-level Social Work Practicum Students

Licensed Professional Counselors

Licensed Professional Counselor Interns completing Clinical Hours

Graduate-level Counselor Practicum Students

Licensed Marriage & Family Therapists

Licensed Marriage & Family Associates completing Clinical Hours

Graduate-level Marriage & Family Practicum Students

FAQ: What can Counseling help me or my family with?

 

Depression or General Sadness

Anxiety, Fears, Persistent Worries

Behavior Problems

Parenting Support & Assistance

Marriage Counseling

Life Struggles, Loneliness

Trauma & Hard Life Events

Divorce 0r Challenges Co-Parenting

Faith-Based Counseling

Alliance Connect

Telehealth Counseling for ALL Texans

a program of Alliance Child & Family Solutions

© 2020 by Alliance Child & Family Solutions

parent organization website at: www.acfstexas.com