Patient Forms

Welcome to Illinois Eye Center! Upon your first visit with us, please complete the New Patient Forms prior to your arrival. This includes the HIPAA Release of Information and Authorization for Medical Benefits Forms. 

We’ve also included a Records Release form for your convenience. If your child will be attending an appointment without a parent or guardian, please compete the Consent for Treatment of a Minor form.

Weather Alert

Current forecasts call for winter weather overnight in the Peoria area. Please check Illinois Eye Center’s website for the latest information on closures or delayed opening that may impact your appointment on Friday January 10. If you prefer to request a reschedule of your appointment now, please use the link below.

Reschedule Appointment

Notice: Online Forms Are Temporarily Unavailable – Resolution in Progress

We are currently experiencing an issue with our form technology provider. If you’d like to request an appointment, please call (309) 243-2400.