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Cynthia Broad, Optometry Patient History Questionnaire Today's Date: Full Name: Birth Date: Address: Social Security #: Home Phone*: Email Address: Cell Phone: Occupation: Work Phone: Circle which
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Start by gathering the necessary information, such as your personal details and medical history.
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Contact Cynthia Broady Optometry to schedule an appointment.
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Arrive at the optometry clinic on time for your appointment.
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Meet with the optometrist and discuss your eye health concerns or reasons for the visit.
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Follow the instructions provided by the optometrist during the eye examination.
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Provide accurate responses to questions asked during the examination.
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Cooperate with the optometrist while they conduct tests or evaluations.
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Listen carefully to any recommendations or treatment plans suggested by the optometrist.
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If necessary, choose and purchase any prescribed eyeglasses, contact lenses, or other eye care products.
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Follow up with Cynthia Broady Optometry as instructed for further appointments or check-ups.

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Anyone who requires professional eye care services, including comprehensive eye examinations, diagnosis and treatment of eye conditions, prescription of eyeglasses or contact lenses, and general eye health care, can benefit from Cynthia Broady Optometry.
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Cynthia Broady Optometry is a professional practice focused on providing eye care services, including vision exams, prescription of glasses and contact lenses, and management of ocular diseases.
Individuals seeking eye care services at Cynthia Broady Optometry are typically required to complete intake forms and provide necessary personal and insurance information.
To fill out forms for Cynthia Broady Optometry, patients should provide accurate personal information, medical history, and any insurance details required on the forms provided during their visit.
The purpose of Cynthia Broady Optometry is to deliver comprehensive eye health services, ensure proper vision correction, and educate patients about vision care.
Patients must report personal identification details, medical history, current medications, and eye health concerns when seeking services at Cynthia Broady Optometry.
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