Jerry Jacobs, OD

  • Welcome to our Office

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  • If taking any, please list
  • If you have any, please list
  • If yes, how often?
  • Vision History

  • If so, when?
  • Contact Lenses

  • 100%, 50%, occasionally, etc.
  • Check if occur
  • Do you have any of the following?
  • If yes, how long ago?
  • If yes, how often and what part of the head?
  • I've been given the opportunity to review the Notice of Privacy Practice.
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