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New Patient Form

Mountain Eye Care, PC

Billing and Insurance

Medical Insurance

Assignment and Release

I certify that I and/or my depends have insurance coverage with the insurance(s) listed above and assign directly to Mountain Eye Care, PC all insurance benefits, if any, otherwise payable to me for services rendered. I understand that I am financially responsible for all charges whether or not paid by insurance. I authorize the use of my signature on all insurance submissions.

What is Your Reason For Today's Eye Exam?

Patient Medical History

Review of Systems

Social History

Family History

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THIS ---->https://mountaineyecare.imatrixbase.com/new-patient-center/new-form.html

Office Hours

DayMorningAfternoon
Monday8:15-121-5
Tuesday8:15-121-5
Wednesday8:15-121-5
Thursday8:15-121-5
FridayClosedClosed
SaturdayClosedClosed
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8:15-12 8:15-12 8:15-12 8:15-12 Closed Closed Closed
1-5 1-5 1-5 1-5 Closed Closed Closed

Testimonial

I appreciate the attention to detail and follow-up of the eye care Mountain Eye Care provides. The front office staff was polite and the choices of frames was great.

Donnie
Blairsville, GA