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161 fashion lane #110 Tustin, CA 92780

(714) 225-8840

transformingcouples@icloud.com

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161 fashion lane #110
Tustin, CA 92780

transformingcouples@icloud.com
(714) 225-8840

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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.