Please feel free to contact us:

281-955-0050 281-955-0199

PATIENT REGISTRATION FORMS

Kristina Fernandez, LPC offers new patient registration forms online so you can complete it in the convenience of your own home or office.


Download the form below, print it out and fill in the required information and bring it with you to your appointment.


The form does require AdobeReader® installed on your computer to open the PDF file. If you don’t have a version Click Here to Download.



ADULT PATIENTS


ADOLESCENT PATIENTS

TINA
PSYCHOTHERAPIST

I am a licensed LPC-Supervisor.

I supervise LPC interns as they achieve their 3000 hours necessary to qualify for their LPC license.

Board Certified PTSD Clinician

Certified Relationship Counselor