Patient Forms

For your convenience new patient paperwork is available on your patient portal. Please call our office at 847-253-4040 to provide a valid email address so we may configure. If you have already received your welcome email please go to your Patient Portal.  

Dilation Facts and Information

Financial Policy

Self-Pay Waiver/Patient Financial Responsibility Form

Medical Record Release Forms

Authorization Release FROM SAO

Authorization Release TO SAO

 Notice of Privacy Practices
 HIPAA Patient Acknowledgment and Consent - SAO
HIPAA Notice of Privacy

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Suburban Associates in Ophthalmology

Suburban Associates in Ophthalmology is an Illinois Ophthalmologist group dedicated to excellence in ophthalmology such as laser refractive surgery, LASIK, eye exams, glaucoma care, contact lenses, glasses and more. Office locations include Arlington Heights, Hoffman Estates and Elk Grove, IL.

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