Appointment Request

Please complete the form below to schedule an appointment.
I will try my best to accommodate your request and will be in touch ASAP.


The power you have is to be the best version of yourself you can be, so you can create a better world. Ashley Rickards

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.


90 North Broadway
Irvington, NY 10533


empoweredwellnessmhc@gmail.com
(845) 416-5041

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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.

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