Dear Patient,

Welcome to Mosier Eye Center! We appreciate your selection of our office and we look forward to serving you for all your eye care needs. This packet was created to provide you with some valuable information regarding your upcoming visit. Please review this letter and take a moment to complete the new patient forms. It is essential to bring the items listed below to your appointment. We realize that your time is valuable and completing these forms in advance will save you time in our office.

Please bring:
o Photo ID
o Medical insurance cards and vision insurance information (if applicable)
o Out-of-pocket financial responsibilities (i.e. copay, deductible, co-insurance, etc.)
o New patient packet (enclosed)
• Patient Registration Form
• Medical History Form
• Patient Consent of Privacy Practices
o Current glasses/contact lens boxes, vials or past prescription (if applicable)
o Medical records from former eye doctor (if applicable)

If you have a list of medications, please bring it with you and we can make a photocopy. Otherwise, list medicines on the medical history form in the provided line.

Appointments usually take 1½ – 2 hours. As part of a thorough exam, your eyes will be dilated, unless medically contraindicated. Most people are able to drive following dilation. If you have experienced problems in the past or if your eyes have never been dilated, you may want to bring a driver. You will experience light sensitivity and difficulty with close-up work following dilation. The dilation will wear off in approximately 2-5 hours.

If the patient is under 18 years old, a parent or legal guardian must be present at the initial appointment. A waiver may be signed for subsequent visits.

Our office is located at 265 Laguna Road in Fullerton. We are near the cross street of Bastanchury and Laguna Road. You will find our office north of Bastanchury, past the Wells Fargo bank on the right hand side.

We look forward to seeing you.

PLEASE DOWNLOAD THE NEW PATIENT FORM BELOW. FILL IT OUT AND RETURN VIA EMAIL OR MAIL IT IN.