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Interested in our programs?

Platform Behavioral Support Services provides many programs and services in Houston and surrounding cities. To make an appointment with us, don't hesitate to contact a member of our Intake Department by calling 713-360-7375 or emailing us at 

For all programs & services of Platform Behavioral Support Services:
Open from Monday to Friday, 9:00 am to 5:00 pm Saturday - as needed
Phone: 713-360-7375

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List all medications and Prescribers
Presenting Problems (Check all that apply below)
Note: If suicidal, homicidal, gravely impaired or need further clinical guidance contact a licensed clinician to further assess for triage! Document clinical disposition when applicable.
Are you allergic to any medications?
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Are you currently pregnant?
Are there any medical problems that you are currently receiving treatment for?

                                                              I authorize payment directly to Platform Behavioral Support Services for services provided.

                                   I authorize or request l Platform Behavioral Support System to release or obtain my confidential medical information (verbal or in writing) to or from any person, provider, health insurance company or organizations involved in my healthcare for quality management, utilization review, treatment purpose, transfer, and follow-up purposes.

                                                    I acknowledge that I have received and read the Notice of Privacy Practices.

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