Online Forms

At Illinois Eye Associates, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReader® to download and complete the forms. Click here to download.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

New Patient Registration Form – Required

Download & Print Form

Download the Free AdobeReader®


Illinois Eye Associates will strive to provide the highest level of patient care and satisfaction.  Our goal is comprehensive, quality eye care that is cost effective for the communities we serve.  We will utilize the most advanced technology and materials available to provide compassionate, personalized care to every patient we serve.  An emphasis will be placed on educating patients about their conditions as we feel this is a key component in our efforts to decrease preventable forms of vision loss. Our doctors and staff will discuss the latest treatment options available with each patient to assure the best clinical decisions are made. Teamwork is an essential part of our practice, with each staff member being an integral piece of our positive work environment.  Through experience, efficiency, and attention to detail our doctors and staff will work together to satisfy your vision needs.


At Illinois Eye Associates we believe in providing our patients "Vision for Life".  We feel the best way for our patients to maintain healthy vision throughout their life is to be educated on conditions that may affect their visual system now or put their vision at risk in the future.  Using cutting edge technology we strive to inform, monitor, and provide customized treatment plans to provide the best chance of maintaining "Vision for Life".