Appointment Request

Interested in learning more about an individual, couples, or group session? Give me a call, send an email, or use the form below to request an appointment. I look forward to hearing from you.

  • Date Format: MM slash DD slash YYYY
    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.