• Appointment Request

    Appointment Request

    Please feel free to complete the form below or use my contact information to request an appointment.
    I will respond as soon as possible.

    3724 Jefferson St., Ste 206
    Austin, TX 78731

    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.