Dr. Veda Szeto Optometry Patient Form

  • Dr. Veda Szeto Optometry

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  • IMPORTANT: This questionnaire is to be reviewed at each appointment. Please answer all questions.

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  • Medical Information

    Please check all that apply.
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  • Family History

  • Personal Eye Information

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  • Doctor use only

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  • I understand my right to privacy under HIPAA.
  • I have read and understand your office policies.
  • Please visit our website to read more about our office policies and your protection under HIPAA