Patient Forms

Doctor at checkin desk at medical office

Registration Form

Download the Patient Registration Form with the link above. Open with Adobe Reader, fill out all the information and print to bring to the office before your visit.

Hauser-Ross Eye Institute

Patient Medical History Form

Consent for Care and Treatment – ENG | ES

Notice of Billing Practices – ENG | ES

Privacy Practices Acknowledgement – ENG | ES

Hauser-Ross Optical

Patient Medical History Form

Consent for Care and Treatment

Notice of Billing Practices

Privacy Policy Acknowledgement

Lawrence Eye Care – Hauser-Ross Eye Institute

Patient Medical History Form

Consent for Care and Treatment

Notice of Billing Practices

Privacy Policy Acknowledgement

Hauser-Ross Eye Institute – VZN Eyecare

Patient Medical History Form

Consent for Care and Treatment

Notice of Billing Practices

Privacy Policy Acknowledgement

Patient Portal Ways to pay Request an Appointment 1-800-243-2587

Our locations

1630 Gateway Drive
Sycamore, IL 60178
Hours
Mon - Thu: 8am – 5pm
Fri: 8am – 4pm

Optical
Mon - Thurs: 8am - 5pm
Fri: 8am - 4pm

Permanently Closed
6814 Sheridan Road
Chicago, IL 60626
Hours

4659 W. Foster Avenue
Chicago, IL 60630
Hours
Mon: 10am - 7pm
Tues: 9am - 6pm
Wed: 9am - 6pm
Thurs: 10am - 7pm
Fri: 9am - 5pm
Sat: 9am - 3pm

2515 Klein Road
Sycamore, IL 60178