Call Now to Schedule: (904) 733-7333

Client Forms

Client Forms

Let’s get started!
Therapy can begin with completion and submission of the *Contact Me* form or by calling (904)-733-7333, pressing 0 following the initial message to reach the receptionist. We will respond quickly by sending an email to the address you provide. Because we are working to protect your health information, the email you receive will require you to create a password. The password is necessary to submit and receive future correspondence. After creating the password, you will have access to *New Client Forms*. Just fill them out and hit submit.
I need all forms submitted prior to our first visit. Review of your therapy goals and past experiences allows me to better prepare for our visit.

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Clear Thoughts
Clear Goals
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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