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    Getting Started with Us

    Please complete the form below to get started. Please provide whatever information you can that will help us get you connected with what you need. If you have one, include the name of the preferred therapist. And please include your location.

    We will try our best to accommodate your request and will be in touch ASAP.

    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.