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


Download the Free AdobeReader®

Locations

Find us on the map

Hours of Operation

Our Regular Schedule

Arlington Heights - Arlington Town Square

Monday:

10:00 am-8:00 pm

Tuesday:

10:00 am-6:00 pm

Wednesday:

10:00 am-8:00 pm

Thursday:

10:00 am-6:00 pm

Friday:

10:00 am-6:00 pm

Saturday:

8:00 am-3:00 pm

Sunday:

Closed

Glenview - The Glen Town Center

Monday:

10:00 am-6:00 pm

Tuesday:

10:00 am-8:00 pm

Wednesday:

10:00 am-6:00 pm

Thursday:

10:00 am-6:00 pm

Friday:

Closed

Saturday:

10:00 am-5:00 pm

Sunday:

Closed

Barrington - Barrington Village Center

Monday:

9:00 am-5:00 pm

Tuesday:

9:00 am-5:00 pm

Wednesday:

9:00 am-7:00 pm

Thursday:

9:00 am-5:00 pm

Friday:

9:00 am-7:00 pm

Saturday:

8:00 am-12:00 pm

Sunday:

Closed

Testimonials

Reviews From Our Satisfied Patients

  • ""All employees were happy to assist in my questions enabling me to know
    the perfect glasses to enhance the frame of my face.""
    Kathy Hohs
  • "I am a first time customer of Assure Vision in Barrington. I highly
    recommend this practice for their professionalism, great attention to
    detail, customer support and friendly, family atmosphere. They work very
    hard to please and make sure the customer is happy with every aspect of
    their eye care. With confidence, I am truly a repeat customer for a
    lifetime. Thank you for all you do!"
    Anne B.