Park Ridge Location

(847) 823-2127

Secondary Office


Online Forms

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

  • You will need AdobeReader® to download and complete the forms.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Bring completed form(s) to our office on the day of your appointment.

New Patient Health History Form – Required

Please complete this form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals you have regarding your eye health or vision on the form.

Download & Print Form

Release of Medical Records

Download & Print Form

Download the Free AdobeReader®


Find us on the map