Doctor PolitzerDoctor Politzer
Vision Rehabilitation Specialists
  • Low Vision
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  • Dizziness & Imbalance
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Patient Forms

Download, Print, & Complete the Forms Below Before Your Visit

  • Demographics Insurance Form
  • Financial Policy
  • HIPAA
  • Medical Information
  • Medical Questionnaire
  • Systems Review
  • Worker’s Compensation Demographics
  • Complete Your Patient Forms
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