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Online Forms

At Xceptional Eye Care, 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.

New Patient Health History Form – Required

Please complete this form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.

Download & Print Form


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Location

Office Hours

Monday:

11:00 am-6:00 pm

Tuesday:

11:00 am-6:00 pm

Wednesday:

11:00 am-6:00 pm

Thursday:

Closed

Friday:

11:00 am-6:00 pm

Saturday:

10:00 am-3:00 pm

Sunday:

Closed

Testimonials

Reviews From Our Satisfied Patients

  • "This office was very professional. Customer service was outstanding and I recommend their services to anyone looking for a new optometrist."
    -Lasandra C., Chicago, IL
  • "I loved Dr. Hoang! She was very thorough, asked lots of good questions about my medical history and her staff was terrific. I ended up with a beautiful pair of Tiffany & Co black frame with little crystal flowers on each temple. If I weren’t moving out of state this summer, I’d go to her regularly for eye checkups."
    -Marilee K., Chicago, IL
  • "My experience was great! Dr. Hoang was professional and very kind. I definitely feel that my eyes are in good hands! The staff was great, too, they were very helpful."
    -Kelly B., Chicago, IL