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Client Forms

If you are an existing client and want access to your billing documents, secure messaging or practice paperwork click the link below:

Client Portal for existing clients

CBC Notice of Privacy

If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

Authorization for Release of Information

School Referral Form

Medical Referral for Therapy Services

500 Brown Blvd.
Bourbonnais, IL 60914

(815) 214-9766

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.