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  • LOCAL PATIENT REGISTRATION FORM

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  • Patient Financial Obligation Agreement

    I understand that all applicable copayments and deductibles are due at the time of service. I agree to be financially responsible and make full payment for all charges not covered by my insurance company. I authorize my insurance benefits be paid directly to MAR-NIG MANAGEMENT LTD / DR. NIGEL BARKER for services rendered. I authorize representatives of Warrens Eye Care Centre to release pertinent medical information to my insurance company when requested or to facilitate payment of a claim.


  • Dilation

    Please note at this visit your eyes may be dilated and we recommend bringing along a designated driver and a pair of sun glasses.

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