Appointment Request

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Schedule An Appointment

Please complete the form below to reach out to me to request an appointment. I will do my best to return your message within 24 business hours. 

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.