New Patients

New patients

Thank you for choosing Hartzell Rupp Ophthalmology as your family eye care provider in Mechanicsburg, PA. In order to provide you with the most efficient and comprehensive care, we ask that you complete a few forms before you visit. Please click and print the links below and bring the completed forms to your first appointment. If you wish to review the Notice of Privacy Practice before you visit, you can read them here
Notice of Privacy Practices.
Woman with eyeglasses - Eye Exams in Mechanicsburg, PA
Hartzell Rupp Ophthalmology
Review of Systems
Hartzell Rupp Ophthalmology
Patient History
Hartzell Rupp Ophthalmology
Registration Form

Preparing for your appointment

Please arrive at least 15 minutes before your scheduled appointment. Bring your insurance card(s) and photo identification. Please make sure that you obtain an insurance referral from your PCP if one is required for your visit. Dr. Rupp will be unable to see you if your insurance requires a referral and we do not receive one before your scheduled appointment.

Appointment information

Before meeting with Dr. Rupp, your visit will consist of an initial vision screening by an Ophthalmic Technician. The technician will review your health history and complete basic vision tests. If you receive dilating drops in your eyes, you may not be able to see clearly for a few hours. Please consider arrangements for transportation if you will be having a dilated exam and think you may have trouble driving.

Call us with your questions

Our staff is friendly and is happy to help answer any questions you may have. Please give us a call today if you have any questions.
2 Cor. 4:18 - For the things we see now will soon be gone, but the things we cannot see will last forever.”
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