Appointment Request

banner image

Schedule An Appointment

Please complete the form below to inquire about scheduling an appointment.

By checking this box you are authorizing Thrive for Life Counseling LLC to communicate with you via text and/or email.
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.