Appointment Request

Appointment Request

To schedule an individual or couples therapy, a life / career / wellness coaching, or biofeedback / stress management appointment or to obtain additional information about any of these clinical services, please fill out the form below, send an email, or give us a call.

Don’t hesitate to make your personal goals, overall emotional and physical well-being, and relationships a priority today!


"There is no greater agony than bearing an untold story inside you."

~ Maya Angelou from I Know Why the Caged Birds Sing

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

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.