Arlington Heights, IL

(847) 368-9999

Barrington, IL

(224) 407-2020

ARLINGTON HEIGHTS: (847) 368-9999 |

BARRINGTON: (224) 407-2020 

Online Forms

At AssureVision, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReader® to download and complete the forms. Click here to download.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

New Patient Health History Form – Required

Please complete this form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.

Download & Print Form


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LOCATIONS

ARLINGTON TOWN SQUARE  
58 S Arlington Heights Rd
Arlington Heights, IL 60005  
Phone: (847) 368-9999

BARRINGTON VILLAGE CENTER  
143 W Main St
Barrington, IL 60010  
Phone: (224) 407-2020

Hours of Operation

Our Regular Schedule

Arlington Heights - Arlington Town Square

Monday

10:00 am - 6:00 pm

6:00 pm - 8:00 pm Available by appointment only

Tuesday

10:00 am - 6:00 pm

Wednesday

10:00 am - 6:00 pm

6:00 pm - 8:00 pm Available by appointment only

Thursday

10:00 am - 6:00 pm

Friday

10:00 am - 6:00 pm

Saturday

10:00 am - 3:00 pm

Sunday

Closed

Barrington - Barrington Village Center

Monday

9:00 am - 5:00 pm

Tuesday

9:00 am - 5:00 pm

5:00 pm - 7:00 pm Available by appointment only

Wednesday

9:00 am - 5:00 pm

Thursday

9:00 am - 5:00 pm

5:00 pm - 7:00 pm Available by appointment only

Friday

Closed

Saturday

8:00 am - 1:00 pm

Sunday

Closed

Arlington Heights - Arlington Town Square

Monday
10:00 am - 6:00 pm 6:00 pm - 8:00 pm Available by appointment only
Tuesday
10:00 am - 6:00 pm
Wednesday
10:00 am - 6:00 pm 6:00 pm - 8:00 pm Available by appointment only
Thursday
10:00 am - 6:00 pm
Friday
10:00 am - 6:00 pm
Saturday
10:00 am - 3:00 pm
Sunday
Closed

Barrington - Barrington Village Center

Monday
9:00 am - 5:00 pm
Tuesday
9:00 am - 5:00 pm 5:00 pm - 7:00 pm Available by appointment only
Wednesday
9:00 am - 5:00 pm
Thursday
9:00 am - 5:00 pm 5:00 pm - 7:00 pm Available by appointment only
Friday
Closed
Saturday
8:00 am - 1:00 pm
Sunday
Closed

Locations

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We look forward to hearing from you.