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How many refraction's do you do per month?
 
 
Other
 
 
 
 
How many pair of glasses do you prescribe per month?
 
 
Other
 
 
 
 
Are you doing any orthoptic procedures?
 
Yes
 
No
 
 
 
Are you doing school screening?
 
Yes
 
No
 
 
 
Comments/Suggestions:
   
 
 
 
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Streak
 
Lister Bulb
 
Subjective
 
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