Make an Appointment: [email protected] | (252) 724-8819

[email protected] | (252) 724-8819
Contact
  • (252) 724-8819
    [email protected]

    • Client Forms

    Before beginning our sessions, in order to appease the powers that be and protect you and me… please feel free to fill out these intake forms.

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

    Contact

    (252) 724-8819
    [email protected]

    Moyock, NC, Telehealth Only

    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.