logo
(310) 826-1141   |   judi@bucholtztherapy.com

Judi Bucholtz

My WordPress Blog

  • Home
  • About
    • Blog
  • Services
    • Counseling for Anxiety
    • Counseling for Trauma
    • Couples Counseling
    • Depression Counseling
    • EMDR
  • Getting Started
    • Appointment Request
    • Client Forms
    • FAQs
    • Rates & Insurance
  • Resources
    • Mental Health Links
    • Physical Health Links
  • Contact

Client Forms

If you are new to therapy, please be sure to fill out the following forms, and bring them to your first session. This will help ease you into therapy, and allow as much time as possible to be spent focusing on you.

Client Contact Information Sheet

Client Intake

Authorization for Release of Information

Contact Today

Judith J. Bucholtz



Phone: (310) 826-1141
judi@bucholtztherapy.com


Send 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.

Judith J. Bucholtz


Phone: (310) 826-1141
Email: judi@bucholtztherapy.com


Connect With Me

  • Facebook

Get Started

Click on the button below to schedule an appointment with Judith J. Bucholtz

Request an Appointment
Privacy Policy
A Website by Brighter Vision