Request an Appointment

At NLCC, we are interested in trying to connect you with the therapist best suited for your needs.  Thus, even from the first phone call, we believe that a good investment of time for both you and your therapist is to spend approximately five minutes on the phone to gather an idea of what issue(s) may invite you to seek counseling.  And based on this information, your therapist may offer you a referral to another therapist, who may specialize in something that you seek, or offer to set an appointment.

You’re welcome to pursue making an appointment through one of two routes, either by phone or the email contact below, and someone will contact you within 24 hours.  If you choose to phone our office, please leave your contact information on our voicemail system, along with a few other bits of information so that we may pair you with the therapist who may serve you most efficiently:

  • your contact information,
  • whether you would prefer a male or female therapist,
  • whether you would prefer a licensed therapist with more experience or an intern with a more negotiable fee, 
  • and a little bit about what you are wanting to work on.

Or you may submit the form below:

Information and/or Appointment Request  Form


Please answer the simple math question below to submit the form.
2 + 2 =


1st Appointment Forms 

These forms are listed here for our first-time visitors to print at home and fill out ahead of your appointment.  Adult Clients:  Please read #1, and print and fill out #2 and #3 before your first appointment.  For Child-Adolescent Clients, parents/legal guardians, please read #1, and print & fill out #4 before your first appointment.             

  1. HIPAA Consent (please read, no need to print out)            
  2. Personal Data
  3. General Consent to Treatment (Round Rock clients)
  4. General Consent to Treatment  (Southwest clients)
  5. Child & Adolescent Personal Data
  6. Release of Information
  7. Sliding Scale Application 



© 2013 New Life Counseling Center
3000 Joe DiMaggio Blvd.,
Suites #88-89
Round Rock, Texas 78665
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If you are experiencing an emergency, do not wait for a call back from New Life.
Please call 911 or drive immediately to your nearest emergency room.