Hello and Welcome to the Northern Illinois Eye Clinic!
We are pleased and honored to have you as a patient. The following forms can be filled out and printed or emailed to us prior to your visit if you desire. Please click below for a general history questionnaire, our financial policy form, glasses and contacts policy, and HIPAA forms.
Our email: firstname.lastname@example.org
New Patient History Questionnaire (2 pages)
Nuevos Pacientes Historial Medicos (3 paginas)
Patient Financial Terms Agreement (2 pages)
Glasses and Contact Lens Policy (1 page)