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We love you guys!

I am in a wheelchair & will soon be using my quad cane to walk with. On your doors please install automatic door openers. I would give your staff and A+! We love you guys! I am thankful to my Lord to be back with my therapy, pushing toward my full recovery. Please continue to pray my brain get hooked back up. Yours in Christ, Tom & Olinda. Shalom! Maranatha!

5
- Thomas W. Joplin MO

Vision Therapy Assessment Referral Form

  • Section 1: Referring Healthcare Provider

  • Date Format: DD slash MM slash YYYY
  • Section 2: Patient Information

  • Date Format: DD slash MM slash YYYY
  • Refraction & BCVA:
  • Refraction & BCVA: