The Eye Institute Appointment

What should I bring to my appointment?

  • Patients should bring all eyewear currently being used.
  • Patients should bring a list of all prescription and over-the-counter medications currently used.
  • Patients should bring all medical insurance cards and/or referrals acquired from your medical doctor.
    • NPI Number: 1336160027
  • Payment of co-insurance, co-payments, deductibles, or non-covered services, when applicable, is required at the time of service.

What forms do I need to fill out prior to my appointment?

Medical Records Release Form (PDF)

  • Authorization for TEI to release your medical records to another provider (or to request a copy for yourself)

Assignment of Benefits (AOB) (PDF)

  • Authorization for TEI to bill your insurance directly for your care, as well as acknowledgement of patient financial responsibilities

HIPAA Notice of Privacy Practices (HIPAA NOPP) (PDF)

  • This notice describes how health information about you may be used and disclosed and how you can get access to this information

What is The Eye Institute's Cancellation/No Show Policy?

The Eye Institute of Salus University understands situations arise that prevent you from keeping your scheduled appointment. We appreciate it when you notify us in advance that you are unable to keep your appointment as this allows us to accommodate other patients.

We require 24 hours notice to cancel/reschedule your appointment. Should you fail to contact us within 24 hours, you will be charged a $20.00 fee. This fee is the responsibility of the patient and cannot be billed to your insurance carrier.

To avoid this fee, please call 215-276- 6111 or you may respond via The Eye Institute’s text message system to reschedule your appointment at least 24 hours in advance of your appointment time.