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<p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><b style=
=3D'mso-bidi-font-weight:
normal'><span style=3D'font-size:14.0pt'>WELCOME TO OUR OFFICE!<o:p></o:p>=
</span></b></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;mso-bidi-font-size:10=
.0pt'><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;mso-bidi-font-size:10=
.0pt'>Dear
Patient, <o:p></o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;mso-bidi-font-size:10=
.0pt'><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;mso-bidi-font-size:10=
.0pt'>We
welcome you and thank you for choosing us to serve your eye care needs!<sp=
an
style=3D'mso-spacerun:yes'>&nbsp; </span>We look forward to meeting you and
providing the very best eye care and eyewear available today.<o:p></o:p></=
span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;mso-bidi-font-size:10=
.0pt'><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;mso-bidi-font-size:10=
.0pt'>Enclosed
is a <b style=3D'mso-bidi-font-weight:normal'>Patient History</b> form tha=
t we
ask you to fill out before coming into the office.<span
style=3D'mso-spacerun:yes'>&nbsp; </span>Please bring this form along with=
 the
items listed below as this will be a great help to us.<span
style=3D'mso-spacerun:yes'>&nbsp; </span>Also, enclosed is our office <b
style=3D'mso-bidi-font-weight:normal'>Payment Policy</b>.<span
style=3D'mso-spacerun:yes'>&nbsp; </span>Please read this, complete the ba=
ck
side, and sign this form.<span style=3D'mso-spacerun:yes'>&nbsp; </span>Fe=
el free
to call our office if you have any questions.<o:p></o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;mso-bidi-font-size:10=
.0pt'><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;mso-bidi-font-size:10=
.0pt'>When
you come to our office on the day of your appointment, please be sure to b=
ring
the following:<o:p></o:p></span></p>

<p class=3DMsoNormal style=3D'margin-left:.75in;text-indent:-.25in;mso-lis=
t:l0 level1 lfo1;
tab-stops:list .75in'><![if !supportLists]><span style=3D'font-size:12.0pt;
mso-bidi-font-size:10.0pt'><span style=3D'mso-list:Ignore'>1.<span
style=3D'font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </sp=
an></span></span><![endif]><span
style=3D'font-size:12.0pt;mso-bidi-font-size:10.0pt'>List of any medicatio=
ns you
are taking, including any non-prescription medications, eye drops, herbals,
etc.<o:p></o:p></span></p>

<p class=3DMsoNormal style=3D'margin-left:.75in;text-indent:-.25in;mso-lis=
t:l0 level1 lfo1;
tab-stops:list .75in'><![if !supportLists]><span style=3D'font-size:12.0pt;
mso-bidi-font-size:10.0pt'><span style=3D'mso-list:Ignore'>2.<span
style=3D'font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </sp=
an></span></span><![endif]><span
style=3D'font-size:12.0pt;mso-bidi-font-size:10.0pt'>Your vision insurance=
 card
and information, along with your Medicare and major medical insurance
information, if you have any.<o:p></o:p></span></p>

<p class=3DMsoNormal style=3D'margin-left:.75in;text-indent:-.25in;mso-lis=
t:l0 level1 lfo1;
tab-stops:list .75in'><![if !supportLists]><span style=3D'font-size:12.0pt;
mso-bidi-font-size:10.0pt'><span style=3D'mso-list:Ignore'>3.<span
style=3D'font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </sp=
an></span></span><![endif]><span
style=3D'font-size:12.0pt;mso-bidi-font-size:10.0pt'>Your current pair of
glasses.<span style=3D'mso-spacerun:yes'>&nbsp; </span>If you wear contact
lenses, please wear or bring those as well.<o:p></o:p></span></p>

<p class=3DMsoNormal style=3D'margin-left:.75in;text-indent:-.25in;mso-lis=
t:l0 level1 lfo1;
tab-stops:list .75in'><![if !supportLists]><span style=3D'font-size:12.0pt;
mso-bidi-font-size:10.0pt'><span style=3D'mso-list:Ignore'>4.<span
style=3D'font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </sp=
an></span></span><![endif]><span
style=3D'font-size:12.0pt;mso-bidi-font-size:10.0pt'>Completed Patient His=
tory
form.<o:p></o:p></span></p>

<p class=3DMsoNormal style=3D'margin-left:.75in;text-indent:-.25in;mso-lis=
t:l0 level1 lfo1;
tab-stops:list .75in'><![if !supportLists]><span style=3D'font-size:12.0pt;
mso-bidi-font-size:10.0pt'><span style=3D'mso-list:Ignore'>5.<span
style=3D'font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </sp=
an></span></span><![endif]><span
style=3D'font-size:12.0pt;mso-bidi-font-size:10.0pt'>Completed Payment Pol=
icy
form.<o:p></o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;mso-bidi-font-size:10=
.0pt'><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;mso-bidi-font-size:10=
.0pt'>Our
office is located on State Road 14 East (also called <st1:Street w:st=3D"o=
n"><st1:address
 w:st=3D"on">13<sup>th</sup> Street</st1:address></st1:Street>) across fro=
m the <st1:PlaceName
w:st=3D"on">Pulaski</st1:PlaceName> <st1:PlaceName w:st=3D"on">Memorial</s=
t1:PlaceName>
<st1:PlaceType w:st=3D"on">Hospital</st1:PlaceType> and <st1:place w:st=3D=
"on"><st1:PlaceName
 w:st=3D"on">Pulaski</st1:PlaceName> <st1:PlaceName w:st=3D"on">Health</st=
1:PlaceName>
 <st1:PlaceName w:st=3D"on">Care</st1:PlaceName> <st1:PlaceType w:st=3D"on=
">Center</st1:PlaceType></st1:place>
(nursing home).<span style=3D'mso-spacerun:yes'>&nbsp; </span>We are the f=
irst
building west of the bridge on the north side of the road, next to the off=
ice
of Drs. Allman and Johnson.<o:p></o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;mso-bidi-font-size:10=
.0pt'><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;mso-bidi-font-size:10=
.0pt'>Our
office is committed to excellence and personalized care.<span
style=3D'mso-spacerun:yes'>&nbsp; </span>We are so grateful you have trust=
ed us
with your eye care needs.<span style=3D'mso-spacerun:yes'>&nbsp; </span>We=
 look
forward to seeing you!<o:p></o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;mso-bidi-font-size:10=
.0pt'><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;mso-bidi-font-size:10=
.0pt'>Sincerely,
<o:p></o:p></span></p>

<p class=3DMsoNormal><span class=3DGramE><i style=3D'mso-bidi-font-style:n=
ormal'><span
style=3D'font-size:12.0pt;mso-bidi-font-size:10.0pt'>Dennis E. Cowley, O.D=
.</span></i></span><i
style=3D'mso-bidi-font-style:normal'><span style=3D'font-size:12.0pt;mso-b=
idi-font-size:
10.0pt'><span style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp; </span><span
class=3DGramE>Jennifer M. <span class=3DSpellE>Gudas</span>, O.D.</span><o=
:p></o:p></span></i></p>

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