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Helping You Prepare

Online eye care Forms

Everything You Need

Save Time at Your Appointment

At Illinois Eye Associates, we value your time, and we want to make your visit as seamless as possible. To speed up your check-in, you can download and complete your new patient forms before your appointment. This helps us get to know you, understand your vision needs, and prepare for your visit.

Manhattan
monday:
9:00 am - 5:00 pm
tuesday:
9:00 am - 7:00 pm
wednesday:
1:00 pm - 6:00 pm
thursday:
9:00 am - 5:00 pm
friday:
9:00 am - 5:00 pm
saturday:
Closed
sunday:
Closed
Peotone
monday:
Closed
tuesday:
9:00 am - 5:00 pm
wednesday:
9:00 am - 5:00 pm
thursday:
10:00 am - 7:00 pm
friday:
10:00 am - 5:00 pm
saturday:
Closed
sunday:
Closed
A woman in a blue uniform is filling out a form with a pen while a man is looking at her in a hospital setting.

How to Complete Your Forms

  1. Download and print the form below.

  2. Fill out the required information.

  3. Bring the completed form to your appointment or fax it to our office ahead of time.

Note: You’ll need Adobe Reader® to open the form. Click here to download Adobe Reader ›

This form includes your basic information, contact details, health history, and insurance information. Completing it in advance helps us begin your visit with everything we need.

We know navigating vision and medical benefits can feel overwhelming, especially before a first visit. That’s why our team is happy to help you understand what your plan covers, what costs to expect, and how we can coordinate your benefits.

Contact Us

Need help with your paperwork?

If you have questions about which forms to complete, how to fill them out, or what to bring to your appointment, our team is here to help. Just give us a call or send us a message, we’re happy to walk you through it and make sure you feel fully prepared.