Patient Forms

Girl With Glasses

Patient Health History Form (Download Fill out and Print before your appointment)

HIPPA Acknowledgment (Download Fill out and Print before your appointment)

Financial Policy (Download Fill out and Print before your appointment)

DeKalb Optometric delivers quality eye care throughout Northern Illinois, from Rockford to the metro Chicago area. We are always accepting new patients. Call us to schedule your eye exam today! Be sure to bring in copies of all three forms to your first appointment. This process allows us to serve you better!

DeKalb Optometric | | 815-756-6388 | staff@dekalb-optometric.com