If you are in crisis please call 988

Make an Appointment: (336) 837-4499 |   [email protected]

[email protected] | (336) 837-4499
Contact
  • (336) 837-4499
    [email protected]
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    Client Forms

    If you are new, please feel free to fill out these intake forms before our first session.

    If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

    Contact
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    (336) 837-4499
    [email protected]

    Offering Online Services in Winston Salem, NC

    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.

  • Have some questions first? You can always reach out here,
    or email me directly at [email protected]