Chapel Soul Care

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Appointment Request

Please submit all inquiries or questions regarding appointments on the form below.
Intake Coordinator’s office hours are Monday-Wednesday, 9AM-2PM. If you are an existing client, please email Julie at julie@chapelsoulcare.com.

Understand. Heal. Grow. We Can Do This Together
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.