New Patient Forms

Please note: For all new patients, KCPA providers do NOT take insurance.

Help us better understand which provider can best meet your child's needs. 

New Patient Forms must be submitted prior to scheduling an appointment.

Before completing, please also visit our provider page and insurance & rates page to learn more about the specific services that each of our professionals offers.

Click HERE to complete & submit NEW PATIENT FORMS Online

Please allow 15 minutes to complete these forms. 

Please contact Nathalie at 281-829-1599 with any questions or concerns about completing these forms. 

In most cases I will  contact you the same day, or the next business day after receiving the completed forms.

Office Admin hours are: Mon-Fri 11am-5pm

Alternate Print Option -  If you need another method to complete forms please contact me at 281-829-1599

Release of Information  Allows KCPA to share information with another provider.


Dr. James Poysky PhD. Clinical Psychologist/Neuropsychologist.  Evaluations 


Dr. Laurel Casillas PsyD. Post-Doctoral Fellow, Supervised by James Poysky PhD.  Evaluations


Alyssa Muchaw MA, LPC, NCC Counseling/Therapies   

Elizabeth Forman MA, LPC  Counseling/Therapies 


Sarah Joyner MA, LPC, NCC  Counseling/Therapies


Yalda Ahmadi M.Ed, LPC-Associate, Supervised by Tiffany Lindley 


Diana Piquet, Pre-Licensed Counselor, Supervised by James Poysky PhD

Confidentiality & Privacy Policy 

The law protects the relationship between a client and a psychotherapist, and information cannot be disclosed without written permission.

Exceptions include:

Suspected child abuse or dependent adult or elder abuse, for which I am required by law to report this to the appropriate authorities immediately. 

If a client is threatening serious bodily harm to another person/s, I must notify the police and inform the intended victim.

If a client intends to harm himself or herself, I will make every effort to enlist their cooperation in ensuring their safety. If they do not cooperate, I will take further measures without their permission that are provided to me by law in order to ensure their safety.
Privacy Policy

Cancellation Policy

Failure to show for your scheduled therapy or testing appointment, without at least 24 hours advance notice, will result in late cancelation/no-show fee equal to the full visit rate (1-hour) appointment, and $400 fee for each and any testing (2 or more hours) appointment.

By clicking send you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.

Contact Us


Administration Availability -


11:00 am-5:00 pm


11:00 am-5:00 pm


11:00 am-5:00 pm


11:00 am-5:00 pm


11:00 am-5:00 pm