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NEW CLIENT

CHILD INFO FORM

17 yrs and under

NEW CLIENT

ADULT INFO FORM

18 yrs and older

NEW CLIENT

CONSENT for

TREATMENT

Contact Details

Solace Counseling and Anxiety Center

1058 Asher Way, Suite 400, Tyler, TX 75703

(903) 952-3757 (office), (903) 561-8373 (fax)

Solace Counseling Center at Paluxy

1828 E SE Loop 323 Suite LL14, Tyler, TX 75701

(903) 952-3757 (office), (903) 561-8373 (fax)

Business Hours

Monday - Friday, 8 am - 5 pm

(evening times subject to availability)

Saturday, 9 am - 2 pm

(weekend times subject to availability)

Sunday, Closed

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