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Eye Clinic

Eye Clinic - April 29th, 2023

$40 per exam

Please use the form below to submit payment.

Eye Clinic Payment Form

First Name

Last Name

Email

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Select Number of Exams

1 Eye Exam - $40

2 Eye Exams - $80

3 Eye Exams - $120

4 Eye Exams - $160

5 Eye Exams - $200

6 Eye Exams - $240

Thanks for submitting!

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