Richard A. Statesir, MD., Inc.
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Lakewood Eye Doctor Lakewood, OH eye doctor

Patient Forms:

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New Patient Information / Consent Form: Please print this form and fill it out prior to your first visit. It gives us your basic personal information for our records.
 

Health History Form: Please print this form, complete it, and bring it with you to your first visit. It gives us your health history so we may give you appropriate treatment.
 

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