jallenjones5@icloud.com | (239) 351-9970
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3820 Colonial Blvd, Suite 200 | Fort Myers, FL 33907
jallenjones5@icloud.com | (239) 351-9970

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(239) 351-9970

jallenjones5@icloud.com

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3820 Colonial Blvd, Suite 200
Fort Myers, FL 33907

(239) 351-9970
jallenjones5@icloud.com

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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