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*ADD your first initial and last name plus your providers name in the NAME section to protect your identity. We suggest you not fill in your entire name. Consider cleaning your cookies after using online credit card payments. It is your choice to use Square payment. You may also call prior to scheduled appointment to pay any fees. If you have questions or concerns call Ichange at 940-448-0304. If you are in crisis call 911. We strive to better ourselves. Please allow Ichange to grow with first notifying in writing owner at amber@ichangetx.com of any suggestions or complaints and allow 45 business days for changes and actions if necessary. Texas Medical Board 800-201-9352, LPC Board 800-942-5540.

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