Please complete the following form if you would like to contact our office and list the service and/or provider you are seeking, as well as the best time to reach you in the comment section.

Please note:

1. The following form should NOT be used to cancel or reschedule appointments. Please call the office directly at 214.845.7336 if you need to change a scheduled appointment.
2. The following form should NOT be used if you or your child is experiencing a medical or psychiatric emergency. If you or your child is experiencing an emergency, call 911 or go to your nearest emergency room.
3. This form does not meet State and Federal privacy guidelines for sharing of personal health information and your privacy cannot be guaranteed if you choose to use this form. Please do not include any sensitive information or personal health information in the comment section. As an alternative to this form, you may contact the office directly by phone at 214.845.7336.