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Parents

This area is under construction. Please check my blog for updates on current therapy services for parents with kids of all ages.

Name *

E-mail *

Phone

Best Days/Times To Reach You:

Service *

Individual Therapy
Teen Therapy
Therapy for Romantic Relationships

Select all that applies

Are you currently residing in California? *

I am licensed in the state of California and only able to provide services to California residents.

Where would you like to have therapy? *

Online/Secure Video
Office/In-Person

How Can I Help You?

How did you hear about me? *

Ok to leave a voice or text message?

Please review my FAQ's before our 15-minute intake call, as most answers to general inquiries can be found there. Taking the time to read will give us more time to discuss your specific situation when we speak. *

Yes, I will

By submitting this form via this web portal, you acknowledge and accept that risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means. *

Yes, I want to submit this form

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