Online Forms

At Plano Vision Center, 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.

Health History Form – Required

To expedite your check-in time, please complete this form (both pages if patient is a child), then click on the "submit by email" button. If you prefer, you may print the form on a color printer and bring it with you to your appointment.

Download & Print Form

Patient Satisfaction Survey

We appreciate the opportunity to service you. In order for us to accurately direct our efforts to upgrade our services, please complete this Patient Satisfaction Survey (just click on each field with the mouse) and return it to my attention by snail mail or faxing directly to me at 773-924-5241.

Download & Print Form

Download the Free AdobeReader®

Receive 20% OFF* Second Pair of Complete Glasses!

*not valid with other offers


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Office Hours


12:00 pm-8:00 pm


11:30 am-5:00 pm




12:00 pm-8:00 pm


9:00 am-5:00 pm


9:00 am-3:00 pm