Client Contact Form -

Client Contact Form

Please complete this form if your child is an existing ChanceLight® client or you have already completed a New Client Intake Form and would like to communicate with us about your child’s needs, including:

  • Status of intake
  • Waitlist status
  • Scheduling
  • Billing
  • Your child’s therapy team

We will respond to you within two business days to discuss your needs.

The information you provide to ChanceLight® is private and secure, and ChanceLight® will never share your personal information with third parties.

If you are interested in employment opportunities with ChanceLight®, please visit our Careers page to view open positions. This form is not for employment inquiries.




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