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Please select if you are a new patient or if your previous visit was longer than 3 years ago.
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Past Eye History
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Other Past Eye History
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Past Eye Surgery
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Other Past Eye Surgery
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Eye Drops
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Past Laser Procedure
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Family Eye History
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Other Family Eye History
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Eye Related Information
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Are you taking FLOMAX?
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Do you have HIGH BLOOD PRESSURE?
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Do you have DIABETES?
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Do you have THYROID DISEASE?
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