For faster service, please click on the link below that most closely matches your needs:

[Anger Management]  [Life Coach]  [Conflict Resolution]  [Divorce] 

[Grief /Loss]  [Hypnotherapy]

[Individual Counseling]  [Marriage Counseling]  [Parenting]

[Personal Development]  [PTSD]  [Relationships]

[Stress Management]  [ Weight Loss ]

However, if NONE of the above fit your situation , please provide your complete San Diego County area contact information and we'll get back to you right away.  All information is kept strictly confidential.

(Information sent on this form is encrypted for your protection)

Full Name

Family/Company Role   How long?

Problem Area(s)    Stress level

When or how long ago did the problem(s) begin?

Address

City   ZIP code

E-mail (Must be in proper e-mail format: xxx@yyy.zzz)

Telephone (where you want Dr. Colt to call you)

Please describe your situation to the extent you feel comfortable (kept confidential):

How you heard about Dr. Colt or Advance Counseling:   Please choose one: AOL  Search  (please type in your search term on the line below) Backpage.comBing  Search  (please type in your search term on line below) Doctor / Employer referral Family & Marriage Counseling DirectoryFriend / Colleague Google  Search  (please type in your search term on line below) Magazine: (please name on the line below)   "5280: San Diego's Mile-High Magazine" Newspaper: (please name on the line below)   "The Cherry Creek Times"   "The San Diego Business Journal"   "The San Diego Post"   "The San Diego Rocky Mountain News" Radio: (please name the station on line below) Television: (please name the station on line below)   "Good Morning, America" Therapist Directory of San Diego Yahoo  Search  (please type in your search term on line below) YellowPages.com

Search term, please:

ALL fields require an entry, please.  Also, your e-mail address must be in the proper format (xxx@xxx.xxx) or you'll have to re-post your information.