Online Patient Referral Form

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Routine

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Clearwater
St. Petersburg
Tampa
North Tampa

Retina Specialist
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Dr. Cohen
Dr. Eichenbaum
Dr. Billiris-Findlay
Dr. Pautler

Patient Information
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Referring Doctor
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Phone:
Problem: and/or

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Scott Pautler, MD Steven Cohen, MD Karina Billiris-Findlay, MD David Eichenbaum, MD

Tampa Temple Terrace Clearwater St. Petersburg

Office Manager Billing Department Appointments

Tampa Temple Terrace Clearwater St. Petersburg