Insurance Forms

At the Mentoring and Counseling Center, we provide compassionate support for individuals, couples, and teens seeking Counseling services in Texas. To ensure a smooth start to your journey, we have provided all necessary registration and consent forms below. These forms help us better understand your needs and create a personalized approach to your care. Completing them in advance allows more time in your session to focus on your goals. Once complete, please scan and email your forms to [email protected]. If you have any questions about the forms or need assistance filling them out, feel free to reach out—we’re happy to help.

Registration Forms – Provide basic information about yourself, including contact details.
Online Consent Form – Acknowledges your agreement to participate in Counseling sessions, outlining rights and confidentiality.
Credit/Debit Authorization Form – Allows secure payment processing for session fees.
Parent of Adolescent Client Form – Required for minors receiving Counseling, ensuring parental consent and involvement.

Have Questions?

Feel free to contact us at (972) 268-9258.

We’re here to help make your Counseling experience as seamless as possible. If you need help on which Counseling forms to complete or have concerns about any documentation, we’re happy to walk you through the process. Our goal is to ensure you feel comfortable and prepared before your first session.

Teresa Kline

Teresa Kline, Licensed Professional Counselor, created the Mentoring and Counseling Center to expand services for men and women ages 18 to 65, who live in the Montgomery County area and beyond.

We provide Professional Counseling services for individuals, couples, and teenagers (ages 18-65). Virtual sessions are also available for those in the state of Texas.