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Free 15-Minute Consultation

Please complete the form below to schedule an appointment for a free 15 minute consultation.

Please provide options for the best days and times to contact you by phone.

I will try my best to accommodate your request. Our office will contact you within 24-48 hours. We look forward to hearing from you!

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.