Eye Care of Illinois LTD.
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Patient  Forms

Patient Forms


Patient History
File Size: 77 kb
File Type: pdf
Download File

For your convenience, our patient history form is available for you to print and complete before your appointment. Having this form filled out will streamline the exam process and allow us to better serve your time needs.
Payment Policy
File Size: 164 kb
File Type: pdf
Download File

Our payment policy is also available for you to print and review before your appointment.
Contact Us
Eye Care of Illinois LTD
5308 West Main Street
Belleville, IL 62226
Phone: 618-257-9800

Office Hours
Tue     9:00 am - 7:00 pm
Wed    9:00 am - 5:00 pm
Thu     9:00 am - 5:00 pm
Fri       9:00 am - 5:00 pm
Sat      8:00 am - Noon

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​Notice of Privacy Practices
  • Home
  • Our Practice
  • Our Services
  • Patient Forms
  • ORDER CONTACT LENS
  • Eye Care Articles
  • Locations