717-242-1428 | drfbenner@gmail.com

Brighter Visions Counseling

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Client Forms

If you are new to therapy or counseling, please be sure to fill out the following forms, and bring them to your first session. This will help ease you into therapy and allow as much time as possible to focus on you.

Client Intake

Client Information

Authorization for Release of Information

Limits of Confidentiality

 

Contact Today

Brighter Visions Counseling

717-242-1428
drfbenner@gmail.com

Mifflin County
27 N Brown St
Lewistown, PA 17044

Juniata County
22 Industrial Circle
Mifflintown, PA 17059

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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.

Office Hours

Lewistown: 7:00am - 5:30pm Monday - Thursday Mifflintown: 7:00am - 6:00pm - Friday
By special arrangement - Saturday

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Contact Information

Mifflin County
27 N Brown St
Lewistown, PA 17044

Juniata County
22 Industrial Circle
Mifflintown, PA 17059

717-242-1428
drfbenner@gmail.com

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