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    | Southlake TX 76092
    (214) 683-0241 | shameela@therapywithshameela.com

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  • Therapy with Shameela

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    Appointment Request

    Please complete the form below to schedule an appointment. I will try my best to accommodate your request and will be in touch ASAP. If this is a mental health emergency, please visit your local hospital ER or call 911.

    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.

    Shameela Keshavjee, MS, LMFT-S
    (214) 683-0241 | shameela@therapywithshameela.com

    Serving Southlake, Colleyville, Keller, Grapevine, Flower Mound, and Surrounding Areas. Online throughout Texas.

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