Select Location
Select Location
No Preference
Chicago
Highland Park
Hoffman Estates
Arlington Heights
What's Your Concern?
What's Your Concern?
Annual exam
Vision correction consultation
Cataract consultation
Follow up appointment
Dry eye evaluation
Contact Lens fitting or issue
How did you hear about us?
How did you hear about us?
Doctor/Optometrist Referral (Please specify)
Family/Friend
Current/Former Patient
Google/Search Engine
Chicago Cornea Website
Social Media (Facebook, Instagram, Tik Tok, etc.)
Online Ad
Community Event
Insurance Directory
Other (Please specify)
Missed Appointment & Cancellation Policy: We kindly ask for at least 24 hours’ notice if you need to cancel or reschedule your appointment. Missed or late cancellations may result in a $50 fee (not covered by insurance). For full details, please review our Cancellation Policy .
In Case Of Emergency: For any medical emergencies or urgent concerns, please contact one of the locations below at its main line. Our doctors are on-call 24/7 to assist you.
By completing this form, you are giving us permission to follow-up by phone, email or text.