Patient Questionnaire
As Dr. Rosengarten may have discussed with you last year, he is a very strong advocate of yearly eye health examinations.
In order for our office to provide you with the highest levels of service and care, please complete this form and email it to us at Eyedoc1770@aol.com. If you are unable to save the form due to the adobe reader version you have please print it out and fax it to (502) 426-2377.
We can provide better preventative yearly eye health care if we have accurate medical records. Please take your time to answer all questions carefully.
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