Appointment Request

Appointment Request

**Empowerment Counseling & Coaching is no longer accepting clients for 2022. Please fill out the form below for appointments starting in January 2023. For all individuals who submitted a form during December 2022 a staff member from Empowerment Counseling & Coaching will follow up with you in January 2023**.

Please complete the form below to schedule an appointment.
In the message area please specify which therapist you are interested in working with. Empowerment Counseling & Coaching will try its best to accommodate your request and will be in touch.

"Embracing our vulnerabilities is risky but not nearly as dangerous as giving up on love and belonging and joy"

―Ian Morgan Cron.

By submitting this form via this web portal, you acknowledge and accept that 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.