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State of Texas Interagency Eye Examination Report. Examination Report. Patient's Name: Date of Birth: Address: City: State: ZIP Code: Parent/Spouse Name: ...
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Report of Vision Examination DL 62
The applicant takes this form to an opthamologist or optometrist. ... The applicant must complete the top portion of the DL 62 report form, including signing and ...
State of Texas Eye Report
State of Texas. INTERAGENCY. EYE EXAMINATION REPORT. As mandated by Texas law (Senate Bill, 959), this form must not contain information about the ...
a process for receiving and making new referrals - Texas School for ...
The eye report must be less than one year old for new referrals. The eye report does not have to be on the State of Texas Interagency Eye Examination Report ...
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