div class=ts-pagebuttonPage 1button div class=ts-image amp-img class=ts-thumb alt=Page 1: · MICHAEL SETZEN MD FACS FAAP 600 Northern Blvd Suite 312 Great Neck NY 11021 5168290045 fax: 5168290441 PATIENT DEMOGRAPHIC FORM src=https:reader033vdocumentsusreader033viewer2022060711607797f7d0808922fc26f9f4html5thumbnails1jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 2button div class=ts-image amp-img class=ts-thumb alt=Page 2: · MICHAEL SETZEN MD FACS FAAP 600 Northern Blvd Suite 312 Great Neck NY 11021 5168290045 fax: 5168290441 PATIENT DEMOGRAPHIC FORM src=https:reader033vdocumentsusreader033viewer2022060711607797f7d0808922fc26f9f4html5thumbnails2jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 3button div class=ts-image amp-img class=ts-thumb alt=Page 3: · MICHAEL SETZEN MD FACS FAAP 600 Northern Blvd Suite 312 Great Neck NY 11021 5168290045 fax: 5168290441 PATIENT DEMOGRAPHIC FORM src=https:reader033vdocumentsusreader033viewer2022060711607797f7d0808922fc26f9f4html5thumbnails3jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 4button div class=ts-image amp-img class=ts-thumb alt=Page 4: · MICHAEL SETZEN MD FACS FAAP 600 Northern Blvd Suite 312 Great Neck NY 11021 5168290045 fax: 5168290441 PATIENT DEMOGRAPHIC FORM src=https:reader033vdocumentsusreader033viewer2022060711607797f7d0808922fc26f9f4html5thumbnails4jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 5button div class=ts-image amp-img class=ts-thumb alt=Page 5: · MICHAEL SETZEN MD FACS FAAP 600 Northern Blvd Suite 312 Great Neck NY 11021 5168290045 fax: 5168290441 PATIENT DEMOGRAPHIC FORM src=https:reader033vdocumentsusreader033viewer2022060711607797f7d0808922fc26f9f4html5thumbnails5jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 6button div class=ts-image amp-img class=ts-thumb alt=Page 6: · MICHAEL SETZEN MD FACS FAAP 600 Northern Blvd Suite 312 Great Neck NY 11021 5168290045 fax: 5168290441 PATIENT DEMOGRAPHIC FORM src=https:reader033vdocumentsusreader033viewer2022060711607797f7d0808922fc26f9f4html5thumbnails6jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 7button div class=ts-image amp-img class=ts-thumb alt=Page 7: · MICHAEL SETZEN MD FACS FAAP 600 Northern Blvd Suite 312 Great Neck NY 11021 5168290045 fax: 5168290441 PATIENT DEMOGRAPHIC FORM src=https:reader033vdocumentsusreader033viewer2022060711607797f7d0808922fc26f9f4html5thumbnails7jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 8button div class=ts-image amp-img class=ts-thumb alt=Page 8: · MICHAEL SETZEN MD FACS FAAP 600 Northern Blvd Suite 312 Great Neck NY 11021 5168290045 fax: 5168290441 PATIENT DEMOGRAPHIC FORM src=https:reader033vdocumentsusreader033viewer2022060711607797f7d0808922fc26f9f4html5thumbnails8jpg width=142 height=106 layout=responsive amp-img divdiv