In compliance with the "NO SURPRISES ACT" We provide a "Good Faith Estimate" to all clients who do not have insurance or for those who choose not to use your insurance. Please contact our office for more information.

lifeinbalancecenter@gmail.com | 540-381-6215

Contact UsCounseling Intake Packets
400 Roanoke Street, Christiansburg, VA 24073
lifeinbalancecenter@gmail.com | 540-381-6215

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.

If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

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540-381-6215
lifeinbalancecenter@gmail.com

400 Roanoke Street
Christiansburg, VA 24073

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.