Request an Appointment

Please complete the form below to schedule an appointment. 
We will do our best to accommodate your request and will contact you as soon as possible.

The session enabled me to look at things in a different way, 
and to start to think of a plan for the future."

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.