832-330-2567 psalaam@gmail.com

Salaam Counseling

Support for Individuals, Couples, and Families

New Patient Forms

Whether you’re coming for individual, marital or family counseling, I strive to create a safe environment for discussing your problems.

To make your first appointment easier, I’ve included all of the forms you’ll need at the bottom of the page. You may print those forms, complete them at home, and have them ready before you arrive. Please bring the INTAKE PAPERWORK, along with your insurance card and picture identification, to our first appointment.

Insurances Accepted

 Blue Cross Blue Shield

Value Options



Traditional Medicaid




United Behavioral Healthcare


The First Appointment

Our first session is largely information-gathering, and I ask that you have the New Client forms filled out when you arrive.  If you don’t have access to a printer, you may arrive at the office 30 minutes early to fill them out in the waiting room.  

To make the payment part of counseling as easy as possible, I ask all new clients who will be using insurance to call their insurance information into the billing company I use before our first appointment. That phone number is (281) 429-3936. They will verify your benefits and copay, if you have one, and email that information to me.


  1. Client Self-Assessment
  2. Release of Information
  3. Office Policies
  4. Confidentiality Policy

Begin by reaching out today.

For more information or to schedule an appointment, feel free to send me an initial message and we can move forward from there.