Make an Appointment: [email protected] | (917) 524-7663

  • Request for Private Consultation

    banner image

    Consultation Application

    If you’re interested in working together, please complete the form below. Due to the highly personalized nature of my practice, all inquiries are reviewed before scheduling. You may also contact us via call/text or email.

    What specific challenges or goals are leading you to seek therapy at this time?

    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.