Insurance, Fees & Forms 

Family Houston accepts most health insurance plans including Medicare and Medicaid. To see a full list of accepted plans click here.

If you don’t have health insurance or you plan to pay for healthcare bills yourself, we are happy to provide you with a Good Faith Estimate in English or Spanish.

Family Houston is committed to quality care for all clients. You may view your Client’s Rights in English or Spanish.

Billing Contact Information

For claims/billing related questions:

(713) 861-4849
clientinvoices@familyhouston.org

For initial visit for services, updated insurance, or client information:

(713) 861-4849
intake@familyhouston.org

Payment Authorization

Autorización de pago

Intake and Consent Forms 

The following forms serve as a reference so that you understand information that will be required from you when working with Family Houston for services. Required forms will be emailed to you for electronic signature after scheduling your appointment.

Clinical

Authorization for Disclosure of Client Record

Autorización para la divulgación del registro del cliente

Client’s Rights and Responsibilities

Derechos y responsabilidades del cliente

Telehealth Consent for Treatment (Adult)

Consentimiento de telesalud para tratamiento (adulta)

Telehealth Consent for Treatment (Child)

Consentimiento de telesalud para tratamiento (niño)

Telehealth Informed Consent

Consentimiento informado de telesalud

 

Community Support

Community Support Consent for Services

Consentimiento de apoyo comunitario para servicios

Financial Stability

Financial Stability Consent for Services

Formularios de admisión de estabilidad financiera

Veterans

Veteran Support Consent for Services

$60

Covers the average cost of a mental health counseling session.

$120

In honor of our 120th anniversary, helps us continue providing assistance to those in need.

$500

Covers the cost of specialized Post Traumatic Stress Disorder counseling for a veteran.

$1000

Provides a full day of in-school mental health counseling for pediatric patients.