Make an Appointment: 825-966-4348 |   [email protected]

[email protected] | 825-966-4348
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Providing Online Services in Canada
[email protected] | 825-966-4348

  • 825-966-4348
    [email protected]

    • Client Forms

    Please review these forms if  you feel that you would like us to collaborate with other providers about your care. Print and email to the provider 

    Authorization for Release of Information

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    825-966-4348
    [email protected]
    Providing Online Services in Canada

    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.