Appointment Request

To book your free phone consult please complete the form below to schedule an appointment. I will try my best to to get back to you within a 24 hour period. If this is an emergency please contact the Crisis Support Centre Distress Line at 780-482-HELP (4357) or for urgent help the Crisis Response Team at 780-342-7777.

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.

 

If you have more questions please don’t hesitate to contact me.