• Appointment Request

    Appointment Request

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


    “I want to love you without clutching, appreciate you without judging, join you without invading, invite you without demanding, leave you without guilt, criticize you without blaming, and help you without insulting. If I can have the same from you, then we can truly meet and enrich each other.” -Virginia Satir-

    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.