Schedule an Appointment Complete the form below and we will contact you within one business day. Please enable JavaScript in your browser to complete this form.Name *E-mail *Insurance TypePhoneBest Days and TimesWhat Do You Hope to Discuss in Counseling? *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.MessageSubmit
