Make an Appointment: (205) 218-8991 | ChebonPorter@gmail.com

ChebonPorter@gmail.com | (205) 218-8991
Contact
banner image

Client Forms

If you are new, please feel free to complete these intake forms before our first session. These forms can also be completed during the first session.

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

Contact
logo


(205) 218-8991
ChebonPorter@gmail.com

Serving clients in Alabama and Oregon

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.