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Get Clinical Optometry Update & Review Registration ... - Ttuhsc

K. Last Name First Name Street Address City, State & Zip State License #: Telephone COPE/ARBO ID #: Email PAYMENT INFORMATION Check Enclosed Please make check payable to TTUHSC - Ophthalmology Mail to Charity Donaldson at: TTUHSC Ophthalmology 3601 4th Street MS 7217 Lubbock, Texas 79430 Or Fax Credit Card Registrations to: Charity at 806-743-2471 MasterCard Credit Card Number Name as it appears on the credit card (please print) VISA (These are the only major cred.

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