Advance Eye Care

Patient Forms

To better assist our patients, we have provided all our registration forms. At your convenience, please print off all three forms, fill them out and bring them to your appointment. If you have any questions regarding these forms, please leave it blank and we can assist you when you arrive for your appointment.

As of January 1, 2008, Illinois passed a new law requiring all students entering Kindergarten to provide proof of an eye examination. This exam can only be completed by an optometrist or an ophthalmologist and must be completed prior to the child starting Kindergarten (or at which ever age the child enrolls in school). Please print out the form to the left and bring to your child's eye exam. The form will be returned to you for you to submit to the school.

New Patient Registration Form

Illinois School Exam Form

Advanced Eyecare Clinic
45 West Acorn Lane
Lake in the Hills, Illinois 60156
(847) 854-0202
info@advancedeyecareclinic.com
Fax: (847) 854-0299
Hours:
Monday 9:00am - 5:30pm
Tuesday 9:00am - 5:30pm
Wednesday By appointment
(Dr. Janikowski)
Thursday 10:00am - 7:00pm
Friday 9:00am - 4:00pm
Saturday 8:30am - 12:00pm
Sunday CLOSED