Main Office: 2209 Eastern Avenue Plymouth, WI 53073 920-892-7606

Northshore Campus – Sheboygan: 805 North 6th Street Sheboygan, WI 53081 920-457-8866

Port Washington Office, 1000 N. Wisconsin Street, Port Washington, WI 53074

Oostburg Office – 927 Center Avenue, Suite 4, Oostburg, WI 53070

Client Forms

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.

 

 

 



2209 Eastern Avenue
Plymouth, WI 53073

molly@lifepointwi.com
(920) 892-7606

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.