623-208-0059 | lisa@championcounselingaz.com

Lisa Mendoza

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Appointment Request

Please feel free to complete the form below to request an appointment.
You may also call me, or email anytime. I look forward to meeting you!


ABILITY is what you're capable of doing. MOTIVATION determines what you do. ATTITUDE determines how well you do it.
- Lou Holtz

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.

Lisa Mendoza



623-208-0059
lisa@championcounselingaz.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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623-208-0059
lisa@championcounselingaz.com

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