Client Forms

While I have these forms available when you arrive for your first appointment, it will save us valuable time if you would print out, complete and sign the respective forms prior to coming to my office. Feel free to call me prior to your first appointment if you have questions about the forms.

Individual Therapy

Service Policy
Background Information

Couples Therapy

Service Policy for Couples
Background Information

Family, Child and Adolescent Therapy

Service Policy for Children
Service Policy for Adolescents
Background Information Children
Background Information Adolescents

Your Name*
Email*
Phone*
Your Message
Terms of Use*
- Yes, I want to submit this form
By submitting this form via this web portal, you acknowledge and accept the 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.
Name
This field is for validation purposes and should be left unchanged.