Appointment Request

To request an appointment or to obtain additional information about any of our counseling services, please fill out the form below or give us a call at 561-810-6631. We will respond and confirm further details to get started. Thank you.

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.