The Consultative Evaluation Request form is a secure HIPAA compliant form which helps prospective adult patients 18+ (generally ages 25 to 60) connect more efficiently and explore whether Brain and Behavior, PLLC will be a good fit. Please ensure you have reviewed the Brain and Behavior, PLLC Policies section of the website before completing your request. This form helps Brain and Behavior, PLLC determine if we are the practice to most appropriately meet your clinical needs.

Brain and Behavior, PLLC consultative evaluation requests and/or consultations come with no guarantee or expectation of an appointment, treatment, or formation of a physician-patient relationship.

Brain and Behavior, PLLC is out-of-network (does not accept insurance) and does not participate in Medicare or Medicaid.

Brain and Behavior, PLLC does not generally prescribe Xanax, Adderall, stimulants, and/or opioids.

Brain and Behavior, PLLC only accepts Consultative Evaluation Requests filled out by the potential patient (or by his/her Texas medical power of attorney or legal guardian). Family, friends, clinical staff, etc. are not permitted to complete this form on behalf of the potential patient.

If you are or believe you are experiencing a medical or psychiatric emergency, including and not limited to suicidal or homicidal thinking, side effects to medication, or any other urgent or time-sensitive matter in which you need an immediate response, do not use this service. Instead call 911 or proceed to your nearest emergency room.