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Record Transfer Request

For patients transferring records from Dr. Walton’s former practice location, please CLICK HERE for the downloadable PDF file, which may be completed and faxed to the number on the form.

Thank you for the chance to serve you and your vision.

Please note that if you have been referred by your optometrist or ophthalmologist directly to Bennett Walton Vision and you have not had exams or testing performed at Dr. Walton’s former location, you do not need to complete this form.

If you have any questions, please call or fill out the form below.

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