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Appointment Request

Please complete the form below to schedule an appointment. Long waits for help can be frustrating and disappointing, even if they are fairly common. For that reason, I will be in touch within 24 hours unless something makes that impossible.

"The mind creates the abyss, the heart crosses it."

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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