This form is used only for non-urgent group change requests.

For emergencies, please call 9-11.

For urgent requests related to your care at BrightView, please call us 24/7 at 833.510.4357 (HELP).  For non-urgent requests, please fill out the form below.  The information will be shared with your clinical care team, and we will respond within 2 businesses days if a response is needed.