Sheldon Rd Office: (978) 407-3291

Westshore Blvd Office: (813) 281-8955

Client Forms

If you are new, please feel free to fill out these intake forms before our first session. These forms can also be filled out during the first session.

Client Intake Form

Client Information Sheet

Limits of Confidentiality/Therapy Cancellation Policy

Authorization for Use or Disclosure of Protected Health Information

(978) 407-3291

10906 Sheldon Rd.
Tampa, FL 33626

1211 N. Westshore Blvd. Suite 100
Tampa, FL 33607


Have Questions?
Send me a Message!

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.