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Advanced Vision - Dr. Spencer Young, OD

  • General Information

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  • Case History/Reason for Visit

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  • If yes, please list what type
  • If yes, which eye?
  • If yes, why?
  • If yes, why?
  • If yes, when were you diagnosed?
  • If yes, when were you diagnosed?
  • If yes, when were you diagnosed?
  • Please check any that apply
  • Personal Medical History (Review of Systems)

    Please check any that apply
  • If yes, how much?
  • If yes, how much?