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w w w . k i r k e y e . c o m :: SITE LAST UPDATED: 10.13.2011  
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Patient Forms

Patient Forms

For your convenience, we have made our New Patient Information form available for patients to download. If you are new to our practice, we encourage you to download and print out this form. Filling this out in advance of your first visit will minimize the time you spend in the waiting room filling it out when you get here. Other forms are informational. If your doctor has given you a form with specific information or instructions different from the information on these online forms, rely on the information given to you by your doctor, not on the online forms. If you're not sure which forms you need, please call 708.771.3334 for assistance or email us your questions at info@kirkeye.com.

If you're unable to open these files, you probably need to download the free Adobe Acrobat Reader program, which is available at the following location: www.adobe.com/products/acrobat/readstep.html

Click on the forms you would like to download:

VISIT US AT: 7427 Lake Street, River Forest, IL 60305
PH: 708-771-3334 | 1.800.KIRKEYE (547-5393) | FAX: 708-771-0841 EMAIL: info@kirkeye.com


Meet the Doctors
·  Scott H. Kirk, M.D.
·  Kent A. Kirk, M.D.
·  Dean Bauer, O.D.

News
·  Kirk Comments on New Science of LASIK
·  Kirk Eye Center Announces Refractive Program for the Disabled

Events
·  Speakers Bureau

Affordable Payment Options
·  Learn about the flexible monthly payment option offered to patients.

Links
·  We have links to several other sites that may help you

Appointments
· Schedule a consultation with our doctors. Tell us when you would like to visit.

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