Young Adult DBT Group Signup Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Phone *Age *What concerning issues are you looking for help with? *What changes would you like to see? *What do you think about joining a group? *Anything else we should know? *How and when should we contact you? *Can you commit to 12 weekly sessions, plus an intake meeting? *How did you hear about us? *Terms of Use *Yes, I want to submit this formBy 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.EmailSubmit