Make an Appointment: 470-214-9572 | healingheartz2020@gmail.com

healingheartz2020@gmail.com | 470-214-9572

healingheartz2020@gmail.com | 470-214-9572

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Client Forms


If you are new, please feel free to fill out these intake forms before our first session. These forms can also be filled out 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
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470-214-9572
healingheartz2020@gmail.com

806 Pavilion Court
Mcdonough, GA 30253

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.