Appointments | Michael & Michael Counseling

To make an appointment, please call our appointment line at: Your call will be returned within 24-hours. You can also email us at: appts@counselingwiththemichaels.com

"A successful marriage requires falling in love many times, always with the same person"

Name

E-mail *

Phone

Service you are interested in

Preferred Time and Date

Comment or Message *

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. *

Yes, I want to submit this form

Comment