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Patient Registration Form

Please complete the information below and submit the form online, or if you prefer print out the form after full or partial completion, and bring it when you come to our office.

This form contains confidential information and is delivered to your doctor through a secure Internet connection.

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Advantage Vision Center will be celebrating Ms. Anne’s 76th Birthday on February 24th. We would like to wish her a healthy and happy birthday. Thank you for being a part of our office.