Appointment Request

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Existing Client Self-Scheduling Client Portal

SCHEDULE A FREE 15 MIN CONSULTATION

Please complete the form below to schedule a free 15-minute consultation and indicate what type of insurance and/or county you live in for Medicaid. Thanks!

We will try our best to accommodate your request and will be in touch ASAP.

Feel free to email or text at the number below for a faster response. 

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.