Client Forms

Below are helpful forms for new and current clients.

Client Intake Form

Notice of Privacy Practices

Authorization For Release of Information

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(331) 303-8600
info@precisionaba.com

1813 N. Mill St. Suite A
Naperville, IL 60563

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This portal is not protected. Please refrain from sending any personal information including name, date of birth, or diagnosis. You can also email us directly info@precisionaba.com.

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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.

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Contact Information

1813 N. Mill St. Suite A
Naperville, IL 60563

(331) 303-8600
info@precisionaba.com

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