New Client Application
Please answer the questions below. They will enable us assign you to a Psychotherapist at A Brighter Journey Counseling Services. If you have questions or concerns, please email us at clientservices@abrighterjourney.com.
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Today's Date
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Client Name *
If Client is a Minor, Client's Parents/Guardians
Client Email (for Client Portal Access) *
If Client is a Minor, Client's Parents/Guardians Email
Client Phone number *
If Client is a Minor, Client's Parents/Guardians Phone Number
Client Age *
Desired Psychotherapist *
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