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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.

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(267) 282-1175

sdavis@drshadanadavis.com

Two Bala Plaza, Suite 300 Bala Cynwyd, PA 19004



Two Bala Plaza, Suite 300
Bala Cynwyd, PA 19004

sdavis@drshadanadavis.com
(267) 282-1175

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DISCLAIMER: This form is not HIPAA Compliant. Do not send any protected health information via this contact form.
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.