Huntley Eye Care
Huntley Eye Care

Online Forms

Due to COVID-19, for the safety of our patients and staff, we are requesting all patients with appointments to complete all consent forms online and submit it back to the office before the day of your appointment.


We are hoping this will limit the exchange of paperwork between patient and staff; therefore, lowering any risk for our patients and staff. Thank you for your cooperation during this unprecedented and difficult time.

If you have multiple family members that need eye examinations, filling out the form at home will greatly help our staff when your family arrives for their appointments. This allows us to begin your eye examination process in a more timely manner.

CURRENT Patients:

If you are a CURRENT patient of our office and coming in for your yearly eye examination, you will have to complete:

1. Annual Consent Form

NEW Patients:

If you are a NEW patient to our office coming in for your yearly eye examination or for an office visit, you will have to complete:

1. New Patient Registration Form

2. Annual Consent Form


We realize that filling out forms is never enjoyable, but the information is critically important to us so that we may provide you with a more personalized eye care experience. Please fully complete the form, including all personal and medical history, so that we may provide you with the eye care you deserve.

Office Forms for Patient Review

Below are the links to our office Financial Agreement and HIPAA Policies for our patient's review. You may print out a copy for your records.

Record Release Authorization From

Please use the form below if you need records sent to our office (from your previous eye doctor) or if you are requesting a copy of your records from us (to be sent to another office).

Patient Registration

Complete our patient registration forms online.


Current Promotions

Amazing Deals Going On!


Office Hours

Our office hours are:


Sunday: Closed

Monday: 9:00 am - 6:00 pm

Tuesday: 9:00 am - 6:00 pm

Wednesday: 9:00 am - 6:00 pm

Thursday: 9:00 am - 6:00 pm

Friday: 9:00 am - 2:00 pm

Saturday: Closed

Contact Us

Huntley Eye Care
11809 East Main Street
Huntley, IL 60142


Phone: (847) 515-2030




Or just use our contact form.

Print | Sitemap
©2022 Huntley Eyecare, LLC