Name *

First Name

Last Name

Phone *

(###)

###

####

I prefer to be contacted by *

Email

Phone Call

Text

I understand that Dr. Jun provides superbills for session payments but does not bill insurance directly. Fees for therapy typically range from $275 to $365. *

Yes

No

I understand I have to be a California resident to receive therapy services. *

Yes

No

I understand there may be limited in-person times available and would be willing to proceed with virtual therapy if that is the best fit. *

Yes, I understand and prefer virtual therapy

Yes, I understand and am open to virtual if it is the best fit

Yes, I understand but prefer in-person therapy

No, I am only looking for in-person therapy