Parenting & Family Solutions, LLC

Counseling Appointment Request

Please complete the form below to schedule an appointment with one of our counselors. We will try our best to accommodate your request and will be in touch typically within 24 business hours.

By submitting this form via this web portal, you acknowledge and accept that 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.
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