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Page 1: New Patient Forms - Gastroenterologist Oceanside, CA3923 Waring Road, Suite A Oceanside, CA 92056-4499 Thomas C. Krol, M.D. M. Eric Viernes, M.D. ... are taking the drug. Please include

Page 2: New Patient Forms - Gastroenterologist Oceanside, CA3923 Waring Road, Suite A Oceanside, CA 92056-4499 Thomas C. Krol, M.D. M. Eric Viernes, M.D. ... are taking the drug. Please include

Page 3: New Patient Forms - Gastroenterologist Oceanside, CA3923 Waring Road, Suite A Oceanside, CA 92056-4499 Thomas C. Krol, M.D. M. Eric Viernes, M.D. ... are taking the drug. Please include

Page 4: New Patient Forms - Gastroenterologist Oceanside, CA3923 Waring Road, Suite A Oceanside, CA 92056-4499 Thomas C. Krol, M.D. M. Eric Viernes, M.D. ... are taking the drug. Please include

Page 5: New Patient Forms - Gastroenterologist Oceanside, CA3923 Waring Road, Suite A Oceanside, CA 92056-4499 Thomas C. Krol, M.D. M. Eric Viernes, M.D. ... are taking the drug. Please include

Page 6: New Patient Forms - Gastroenterologist Oceanside, CA3923 Waring Road, Suite A Oceanside, CA 92056-4499 Thomas C. Krol, M.D. M. Eric Viernes, M.D. ... are taking the drug. Please include

Page 7: New Patient Forms - Gastroenterologist Oceanside, CA3923 Waring Road, Suite A Oceanside, CA 92056-4499 Thomas C. Krol, M.D. M. Eric Viernes, M.D. ... are taking the drug. Please include

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