Forms for Clients

These forms can also be filled out before your session with the Client Care Coordinator. Please bring the following to your first appointment:

  • Paperwork
  • Insurance Card
  • Co-payment (please call your health insurance provider to determine what this may be).

If being referred by FASAP or a lawyer, please bring court documents or anything else that may be pertinent to your case.

Adult Intake Questionnaire

Registration Packet

Community Based Therapy Release Form

Fillable Minor Questionnaire 13yrs and older

Fillable Minor Questionnaire 0-12yrs old

Send a Message

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.