Hettiger Eye Care Center

1205 North Olive Street, Flora, Illinois 62839

618.662.4045

Toll Free: 1-800.438.8793

Patient Forms

Please take the time to complete these forms and bring to your first appointment. This will allow us to treat you more quickly and minimize your wait.

To print form:

Right click on image

Select 'Print Picture' from drop down menu

Select print from printer menu

Medical History

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Patient History

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Contact us today to schedule an appointment