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Crystal Kasper Od Form
Kasper, OD □Ketty Lee, OD
□Tom Politzer, OD □Robert Prouty, OD □Richard Stewart, MD □Carl Tubbs, MD □First Available
Reason for Referral: Chief Complaint, Ocular History, Visual Acuity, Intraocular Pressures, etc.
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Please Indicate:
InSight LASIK:
□ Refractive surgery consult □ Cross-Linking consult
□ ICL Consult
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