Connect To SPEAK Today

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If you are in crisis, please do not use this contact form. Instead, please call the National Suicide Prevention Lifeline (24-hour suicide prevention hotline at 1-800-273-8255), the Asian LifeNet Hotline (24-hour suicide prevention hotline with services available in Cantonese, Mandarin, Japanese, Korean, and Fujianese) at 1-877-990-8585, or text “NAMI” to 741741. 

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.