Professional Referral Network - Hope and Healing Center and Institute

Interested in Partnering with Us?

We welcome the chance to include you in our local professional referral network. By completing the form below, you’ll be contacted about the opportunity to be included in our professional referral database.

The professional referral database will allow our staff to refer individuals to you and your organization in the Houston area to aid them in their mental health journey.

Someone from our team will follow up with all requests as soon as possible.

Information Needed

Agency/Practice Name:*

What is your title/license?*

Licensed Social Worker
Licensed Professional Counselor
Licensed Chemical Dependency Counselor
Licensed Psychologist
Case Manager
Outreach Coordinator
Other

What is your title/license? Other:*

Please list practice specializations (if any):*

What service is provided?*

What service is provided? Other:*

Population served?*

Children Only
Adults Only
Children & Adults

Cost of Services:*

Is sliding scale offered?*

Yes
No

What type of insurance is accepted?*

What type of insurance is accepted? Other:*

Is your organization inclusive of the faith/religious needs of a client?*

Yes
No

Please list all languages services are provided in:*

Please Note:

A HHCI staff member will contact you to review your recorded responses. HHCI will then determine if your organization will be included in our referral network. Thank you!