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    Greetings! Please complete the form below to send us a message. Our Intake Department will be in contact with you if you reach out before 4:00pm EST Monday through Friday or the very next business day if it is on the weekend or after hours. Our office is closed Wednesday-Friday Thanksgiving week and the week between Christmas and New Year’s Day. Thank you again for contacting us.

    If you prefer to register yourself you may do so at ttps://ascensionohio.mytheranest.com/account/signup and our front office will follow-up with you within 1 business day to complete your registration and schedule your first appointment with your counselor. 

    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.