Client Forms

New client, please feel free to fill out these intake forms and send them to the office.

Client Intake Form

Information Sheet

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

Authorization for Release of Information

 

Contact Today




Baltimore, MD 21231

Annie@SpecialEdGuidance.com
(410) 630-1209

Got Questions?
Send a Message!

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.