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    Request an Appointment

    Please complete the form below to request an appointment.

    We will be in touch as soon as possible and confirm your request or suggest another time if necessary. Feel free to call us at the number below to ask questions or to set up an appointment. 

    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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