aoc outreach services
Dallas Get Started Form
Fill out The Intake Form Below
Making Referrals to AOC Outreach Services
Your healing journey begins with our simple online enrollment form. Please provide us with the client’s personal information to start the initial enrollment process. Once you have submitted all required information below, your request will be reviewed by an AOC Intake Specialist.
Child or Patient Details:
- The full name of the child or patient
- The date of birth of the child or patient
- The social security number for the child or patient
- The child or patient’s home address
Legal Guardian/Parent Details:
- The Guardian/Parent full name
- The Guardian/Parent phone number
- The Guardian/Parent personal email address
Health Insurance Details:
- The child’s insurance provider
- The child’s insurance policy number
Medical Details:
- The name of the child’s medical doctor or primary care provider
- The name and dosage of current medication prescriptions (If Any)
Educational Background:
- The name of the child’s school
If you received the link to this page, you are filling out the form to join us Dallas (Region 7)
Our region 7 team is proud to serve the Dallas, Texas community & the families that call the city and surrounding areas home.
Reach out
Phone Number: 1-855-AOC-6100
24 Hours Crisis Line: 832-934-7770
Hours: Monday-Friday 9-5PM
Location: Houston & San Antonio areas
Houston Email: admin@aocoutreachservices.com
San Antonio Email: admin.sa@aocoutreachservices.com
Insurance Accepted
Medicaid: Texas Children Health Plan, Superior Health Plan, Molina Healthcare, United Healthcare
Private: Aetna, Blue Cross Blue Shield, & Cigna
Offices
Houston Office: 6671 Southwest Freeway, Suite 675, Houston, Texas, 77074
San Antonio Mailing Address: 45 Northeast Loop 410 Suite 207, San Antonio, Texas 78216
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