Client Portal Request Appointment

kelly@breathedeepcounseling.com | 636-936-9955
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Reach out today!

You may use the form below to send a message if you are interested in our services. Please indicate if you are looking for in-person or virtual sessions, as well as, daytime or evening preference. If you will be utilizing your health insurance benefit, please include the name your health insurance provider. Please allow 2-3 business days for a response.

636-936-9955

kelly@breathedeepcounseling.com

1137 North Main Street, Suite 2, O'Fallon, MO 63366

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.