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Patient DOB / / Sex Date / / Whom may we thank for your referral? Reason for visit Last Eye Exam? Doctor? Last Medical Exam? Doctor? Do you have any of the following eye related symptoms? Redness
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What is dr john xethalisnew patient?
Dr. John Xethalisnew patient is a new patient form that needs to be filled out by individuals who are seeing Dr. John Xethalis for the first time.
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Any new patients seeing Dr. John Xethalis for the first time are required to fill out the dr john xethalisnew patient form.
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To fill out the dr john xethalisnew patient form, individuals must provide their personal information, medical history, and reason for their visit.
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The dr john xethalisnew patient form must include personal information, medical history, and reason for the new patient's visit.
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