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ABOUT US
DOCTORS
Dr. Sadiqa Stelzner
Dr. Rex Hamilton
Dr. Maria Braun
Dr. Roya Ghafouri
Roxana Khorrami, O.D.
Jason Tran, O.D.
LASIK
LASIK Candidacy
The LASIK Process
LASIK FAQs
SMILE Vision Correction
PRK
Video Library
CATARACTS
Video Library
EYE WEAR
Lens Types and Options
AESTHETICS
Body Contouring
Stretch Marks
Scar Removal
Melasma Treatment
Botox
Eyelid Surgery
PATIENT INFO
Eye Diseases
Glaucoma
Pterygium
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Patient Forms
Medical Portal
Patient Forms
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2018-12-03T21:41:02+00:00
Patient Forms
Patient Medical History
Financial Disclosures Registration Form
New Patient Registration
Request Appointment
Name
*
First
Last
Birthday
*
Email
*
Preferred Phone Number
*
Date Available On or After
*
New Patient?
*
Yes
No
Insurance
Purpose for Request
*
Preferred Days of the Week
*
Monday
Tuesday
Wednesday
Thursday
Friday
Preferred Time of Day
*
AM
PM
Both
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