Client Forms

Our client forms are now accessible online! We will send you a link via email to join our client portal where you can fill the forms out electronically! After you sign them, your counselor will be able to see that they are complete, and you will be ready for your first visit. If you would like to fill them out on paper, you can access them here. We also provide client forms in our waiting rooms as well and if you choose to fill them out at the office, please allow 10-15 minutes to complete.

Informed Consent

Consent to Release Information

Credit Card Form

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95 Enterprise St. Suite 104
Elizabeth, PA 15037

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(412) 754-1100

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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.