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Make An Appointment

New Patient Information Sheet

If you are new to our office and are scheduled for an appointment or would like to schedule an appointment you will need to download this New Patient Information Sheet. Once you have downloaded the form please print it out and completely fill out all 4 pages, sign and date where required, and bring the completed form to our office when you come in for your appointment.


Please, DO NOT wear PERFUME, COLOGNE or SCENTED LOTIONS to your appointment. Please make sure the person(s) accompanying you to your appointment adhere to this rule as well. Our staff members experience a severe allergic reaction to these products, and if you, or the person accompanying you, choose to wear PERFUME, COLOGNE or SCENTED LOTIONS we will have to reschedule your appointment. There are NO exceptions to this rule!


Eyeglass Prescriptions

If you receive a written prescription for new Eyeglasses, replacement glasses, or other, there is a fee due at the time of your visit. NO insurance carrier covers this charge, including Medicare. This is required by Medicare and most eye physicians charge substantially more. Other Doctor’s often charge upwards of $45.00 for this written prescription.

Thank you,
Tri-State Eye


Question: What insurance do you have? Also, If your insurance requires a referral for your appointment, the referral is due at the time of the visit

Our offices accept MOST major insurances.

Our Milford office is currently accepting these insurances:

• 1199
• AARP
• AETNA
• CHN
• CIGNA
• DEVON
• EMPIRE HEALTHCHOICE
• EMPIRE PLAN
• FIRST HEALTH
• FIRST PRIORITY
• GEISINGER
• GHI
• GREAT WEST
• HEALTHNET
• HIGHMARK BLUE SHIELD (PA)
• INDECS
• INDEPENDENCE BC/BS
• MEDICARE
• MULTI-PLAN
• RAILROAD MEDICARE
• MVP
• OXFORD
• PHCS
• SIEBA, LTD.
• UNITED HEALTHCARE
• WATCHTOWER

Our Middletown office is currently accepting these insurances:

• 1199
• AETNA
• ANTHEM
• BEECH STREET
• CDPHP
• CHAMP VA
• CIGNA
• ConnectiCare, Inc. Affiliates
• EMBLEM HEALTH
• EMPIRE BC/BS
• EMPIRE PLAN
• FIDELIS
• FIRST HEALTH
• GHI-HMO
• HEALTH NET
• HEALTH REPUBLIC
• HIP
• HIGHMARK BS
• HORIZON BC/BS
• HUDSON HEALTH SOURCE
• HUDSON HEALTH PLAN
• HUMANO
• INDECS
• MAGNACARE
• MEDICARE
• Most Local Union Insurance Companies
• MULTI-PLAN
• Mutal OF Omaha
• MVP
• National Assoc. Of Letter Carriers
• OXFORD
• PHCS
• RAILROAD MEDICARE
• SIEBA
• TRI-CARE
• UNITED HEALTHCARE
• WATCHTOWER

**You may call our office with any questions regarding your insurance plan**


Question: How will I pay?

Answer: We accept cash, personal checks and credit cards as payment.

Please be aware that your Co-Payment is due at the time of visit.

Below is a list of the credit cards that our offices currently accept.

• VISA
• MASTERCARD
• DISCOVER


Question: How Do I make an appointment?

Answer:

To make and appointment with our Milford Office, please call:
(570) 296-9696

To make and appointment with our Middletown Office, please call:
(845) 703-2020

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