Broken Arrow Neighbors is currently providing low cost vision care to individuals within the area that have NO health insurance or other feasible outlet for this type of service. If you think you can benefit from this program, please fill out the following information, and you will be added as a potential patient for our clinic. A representative of BAN will email or call you to set up an appointment. Please know that it may take several months to receive vision care.
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EMERGENCY CONTACT

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FOR OFFICE USE ONLY