R.N.Roberts Optometrists in Cardiff - Pre Appointment Questionnaire

Have you completed our pre-examination questionnaire before?

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Have there been any changes to your contact details, general health, or personal medication since your last eye examination?

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I confirm there are no changes to my contact details, general health, or personal medication since my last eye examination.

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Please fill in your name, date of birth, email and telephone contact number, then click the box to submit your response

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Date of birth(*)

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