Patient Information

Welcome to Central Pennsylvania Eye Institute

We appreciate the opportunity to take care of you. We try to bring our experts close to you to offer the same care you would receive in the larger cities with greater convenience.

Before your first appointment, we ask you to print out our 3 forms below, fill them out and bring them with you to your visit. Otherwise, you can show up 15 minutes early for your appointment and fill out the forms in our office.

For all your appointments, we ask that you bring:

• Your insurance card(s)
• A referral if required by your insurance (HMO)
• All of your medications

It is our expectation that you will pay your copay and/or visit charges as required by your insurance at the time of your appointment. We do accept Visa and MasterCard for your convenience.

There is a possibility that you may need to have special testing and/or procedures done which can cause your visit to last one to three hours. We make every attempt to see patients at their scheduled times, but unforeseen emergencies may cause a delay.

Forms (pdf's)

• Authorization for disclosure form
  This allows us to share the results of your testing with your referring doctor, your primary care doctor, or anyone else you wish.
  
• Referral form
• History form
  This helps our doctors better diagnose and manage your condition.
  
• Authorization for benefit assignment
  This allows us to report information to your insurance carrier so they will pay for your visit.
• Request for Medical Records
  This form allows us to obtain records from your other doctors and share your exam findings with them as well.

Where to stay in Hershey

Many of our local motels offer discounts to patients coming to the area for medical care. They are also used to helping accommodate our patients after surgery.

Dr R's favorite places to eat

• The Hershey Pantry (Nice lunches)
• The Fractured Prune
• The Cocoa Beanery
• Panera Bread
• The Cocoa Avenue Grill
• Fire Alley
• Al Mediterraneo
• Applebees
• Houlihan's
• Annie's Ice Cream
• Piazza Sorrento
• Dafno’s (Italian)
• Isaacs (Deli)
• Fudruckers (American)
• Friendly’s (American/Nice desserts)
• Dimitri’s (Greek)
• JoJo’s (Pizza)