Make an Appointment: 408-827-1219 | [email protected]

[email protected] | 408-827-1219

[email protected] | 408-827-1219

  • 408-827-1219
    [email protected]

    • Client Forms

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    If you are new, please feel free to fill out these intake forms before our first session. 

    If you would like for me to collaborate with another provider regarding your treatment, simply fill out the following form.

    Contact
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    408-827-1219
    [email protected]

    1000 Fremont Avenue, Suite #270
    Los Altos, California 94024

    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.