• Client Appointment Request

    banner image

    Schedule an appointment

    This form is for adults seeking psychotherapy or an individual consultation. 

    Immigration attorneys should use the attorney referral page.

    Please complete the form below to schedule an appointment.
    I will try my best to accommodate your request and will be in touch ASAP.

    CLICK HERE TO SEND A SECURE MESSAGE

    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.