Confidential Appointment Request

Please complete the following to request an appointment with Dr. Amy Fuller, LMFT, LPC.  This form is confidential and all information entered is protected under the HIPAA privacy act. You will receive an email or phone call within 36-48 hours of submitting this form.  If you would like assistance promptly, please contact Dr. Fuller's office at (832) 848-0870. 

* What is your first name?

* What is your last name?

* What is your phone number?

* At what email address would you like to be contacted?

* Your message:

* Please indicate your preference regarding email.

* Curious if your health care plan will cover counseling? Therapy is covered by most health insurance plans. 
Would you like to use your health insurance or find out what is covered?