top of page

Patient Information

Medical Records

To obtain copies of your medical records for yourself or to provide your personal health information to another doctor or organization, including your last eyeglasses or contact lens prescription, please complete the Patient Information Release Form (Click Here).  Para completar el formulario en español, haga clic aquí.

Once you have filled out and signed the release, please return to the Illinois Eye Institute by mail to: 

Illinois Eye Institute

Attn: Medical Records

3241 South Michigan Ave

Chicago, IL 60616-3878

You may also FAX the completed form to 312-949-7626 or drop it off in person.

If you have questions, please call Medical Records at 312-949-7206.

You can access and download your IEI personal health information and request electronic copies of your eyeglass/contact lens prescription through the IEI Patient Portal HERE.

Looking for mobile applications that allow you to connect to your health information via the Patient Access API?  A current list of third-party API applications is available HERE.

If you would like your doctor to send your medical records to our office, please complete and return to us the Patient Information Receipt Form (CLICK HERE). Para completar el formulario en español, haga clic aquí.

If you are a new patient, please complete and bring in the Medical History Interview Form PDF by clicking on the image. Para completar el formulario en español, haga clic aquí. 

IEI-MedicalHistForm_Img.png
bottom of page