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Thanks to the man who adjusted my glasses!

Thanks to Dr. Jeff for the quick exam and prescription for eye salve. Thanks to the man who adjusted my glasses!

5
- Robert H. Joplin MO

Vision Therapy Assessment Referral Form

  • Section 1: Referring Healthcare Provider

  • Section 2: Patient Information

  • Refraction & BCVA:
  • Refraction & BCVA: