Appointment Request

Appointment Request

Please complete the form below to start the process of getting an appointment scheduled.
We will try our best to accommodate your request and will be in touch ASAP.


"Embracing our vulnerabilities is risky but not nearly as dangerous as giving up on love and belonging and joy"

―Ian Morgan Cron.

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.


433A East Mill Street
Plymouth, WI 53073

molly@lifepointwi.com
(920) 892-7606

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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.