div class=trans-pagebutton class=gotoPage data-page=1Page 1button div class=trans-imagea href=https:reader043fdocumentsinreader043viewer20220309175b68250a7f8b9a68538c31ffhtml5page1jpg target=_blank img data-url=document-one-is-completed-by-your-primary-care-physician-prior-to-your-visit-wehtmlpage=1 data-page=1 class=trans-thumb lazyload alt=Page 1: · one is completed by your primary care physician prior to your visit *We do not accept workmans comp cases or auto identification Of deceased patients loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAQAAAC1HAwCAAAAC0lEQVR42mM8Uw8AAh0BTZud3BwAAAAASUVORK5CYII= data-src=https:reader043fdocumentsinreader043viewer20220309175b68250a7f8b9a68538c31ffhtml5thumbnails1jpg width=140 height=200 adivdivdiv class=trans-pagebutton class=gotoPage data-page=2Page 2button div class=trans-imagea href=https:reader043fdocumentsinreader043viewer20220309175b68250a7f8b9a68538c31ffhtml5page2jpg target=_blank img data-url=document-one-is-completed-by-your-primary-care-physician-prior-to-your-visit-wehtmlpage=2 data-page=2 class=trans-thumb lazyload alt=Page 2: · one is completed by your primary care physician prior to your visit *We do not accept workmans comp cases or auto identification Of deceased patients loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAQAAAC1HAwCAAAAC0lEQVR42mM8Uw8AAh0BTZud3BwAAAAASUVORK5CYII= data-src=https:reader043fdocumentsinreader043viewer20220309175b68250a7f8b9a68538c31ffhtml5thumbnails2jpg width=140 height=200 adivdivdiv class=trans-pagebutton class=gotoPage data-page=3Page 3button div class=trans-imagea href=https:reader043fdocumentsinreader043viewer20220309175b68250a7f8b9a68538c31ffhtml5page3jpg target=_blank img data-url=document-one-is-completed-by-your-primary-care-physician-prior-to-your-visit-wehtmlpage=3 data-page=3 class=trans-thumb lazyload alt=Page 3: · one is completed by your primary care physician prior to your visit *We do not accept workmans comp cases...