National Suicide Prevention Lifeline
1-800-273-8255

info@innerpeacebh.net

Appointment Request

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

Appointments by request only with weekends and evening appointment times available.


Together we can tackle what is holding you back.

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.


100 Maple Street, Suite 208,
Wyandotte, MI 48192

info@innerpeacebh.net
(734) 407-8913
Fax: (734) 258-8229

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.

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