Request An Appointment Use the form on this page to submit a request for a counseling session with Christine Savage. Once you submit the form, someone will get back to you shortly to finalize your appointment date and time. Name* Email* Phone Preferred Date and Time (I will do my best to accomodate and will call within 24 hours)* Time: How Can I Help? By submitting this form via this web portal, you acknowledge and accept that 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. Yes, I want to submit this form Please leave this field empty.