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    • Member Profile Update Form

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    Member Profile Form

    Please complete the following member profile update form with any changes you’d like to make to your existing profile. You may upload a new photo or provide updates by attaching a file in lieu of filling in the fields on this formPlease adhere to these bio guidelines. All profile changes will be reviewed prior to appearing on the website. If your change has not been posted within three weeks, then contact the CDRP Membership Chair.

    This registration form is compatible with Firefox and Chrome web browsers.

    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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    Get in Touch with our Team:

    Please be aware that the form below sends a message to the group Administrator. If you want to contact a Member directly, please locate their contact information at the bottom of their profile page.

    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.