• Appointment Request

    Appointment Request

    Please make sure all paperwork is completed within 24 hours to hold your appointment.

    Please complete the form below to schedule an appointment.

    If you do not get a response within 2 days, we did NOT receive it.

    We will try our best to accommodate your request and will be in touch ASAP.

    "Embracing our vulnerabilities is risky but not nearly as dangerous as giving up on love and belonging and joy"

    ―Ian Morgan Cron.

    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.

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