Appointment Request

Please feel free to complete the form below to request an appointment.
I invite you to call me, or e-Mail anytime. I look forward to speaking with you!

"The glory of God is man fully alive" ~ St.

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.