• Appointment Request

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


    "Shame occurs when you haven't been able to get away with the "who" you want people to think you are."

    - Carl Whitaker


    We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.
    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.