Appointment Request

Please complete the form below to schedule an appointment.
I will try my best to accommodate your request and will be in touch ASAP.


“Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure."
― Marianne Williamson

By submitting this form via this web portal, you acknowledge and accept that 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.