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600 E John Carpenter Fwy, Suite 283

Irving, TX 75062


“Until you make the unconscious conscious, it will direct your life, and you will call it fate.” – C.G. Jung

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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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600 E John Carpenter Fwy, Suite 283
Irving, TX 75062

karina.samaniego@alternativesps.com
(469) 299-5701

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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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