We’re currently seeing all clients online.

We're currently seeing all clients online.

Initial Appointment Request

We are glad that you are taking the first step to begin your journey of wellness. We are providing only Online Counseling sessions. Please complete the form below to help us serve you. For additional questions, You can email hello@liferebirthed.com.


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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