Safe Vision Family Programs
is fully certified and insured.

Schedule an Appointment

Safe Vision Family Programs is a very close relative to what is known in the Health Care industry as Wraparound Support. Our providers directly work with each individual where he or she is most comfortable - whether it is at home or a familiar place in the community.

OFFICE HOURS

Monday – Friday | 9AM – 6PM

Send your service request using the button above. Our service providers have been fully licensed and vetted. We can provide mental health service providers on-site, via mobile device, on a regular basis, or at our offices. Consultative therapy, counseling, and evaluation assessments will be provided by a psychiatrist and a psychologist.

We recommend that you click the "Appointment" button to help us better serve your inquiry. You can also contact us by email or phone.

Service Request Form

Step 1 *Individual/PatientOrganization/Family

Prefix

First Name *

Last Name *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country *

Phone Number *Please provide a telephone number, with area code, so we can contact you.

Daytime Phone

Email Address *Please provide us your email address.

Type of service(s) being requestedMental Health and Medical ServicesPsychiatric evaluation with written reports for Adults, Children, and Adolescent

Please Pick 1 *Adults, Children, and AdolescentAdultsChildrenAdolescent

Psychological testing with scoring for Adults, Children, and Adolescent

Please Pick 1 *Adults, Children, and AdolescentAdultsChildrenAdolescent

Consultation services (supervision & case conferencing with MD)Medication management, script renewal, and follow upTeleMedicine & TelePsychiatry24/7 Psychiatric collaborative consultationPhysical TherapyOccupational TherapySpeech TherapySocial Workers (LMSW, LCSW)Otheryou can select more than 1 service

Other Health Service(s) *Please provide us with other health services that is not listed above

Organization/Family Name *

Prefix2

Contact Person Name *Contact Person

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country *

Contact Person PhoneContact Person Phone Number

Email Address *Please provide us your email address.

Type of service(s) being requestedMental Health and Medical ServicesPsychiatric evaluation with written reports for Adults, Children, and Adolescent

Please Pick 1 *Adults, Children, and AdolescentAdultsChildrenAdolescent

Psychological testing with scoring for Adults, Children, and Adolescent

Please Pick 1 *Adults, Children, and AdolescentAdultsChildrenAdolescent

Other Health Service(s) *Please provide us with other health services that is not listed above

MessagePlease do not include confidential or sensitive information in your message. In the event that we are representing a party with opposing interests to your own, we may have a duty to disclose any information you provide to our client.0 / 180

Please Upload the SIGNED Contract Form Here *

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Appointment Date *

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Safe Vision Family Programs
is fully certified and insured.

Schedule an Appointment

OFFICE HOURS

Service Request Form

Safe Vision Family Programs
is fully certified and insured.

51 Bruckner Boulevard, Bronx, NY 10454

Contact Us

+1 (888) 722-1738

Useful links

Safe Vision Family Programs is fully certified and insured.

Schedule an Appointment

OFFICE HOURS

Service Request Form

Safe Vision Family Programs is fully certified and insured.

Safe Vision Family Programs
is fully certified and insured.

Safe Vision Family Programs
is fully certified and insured.