At Northwest Eyecare, 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.

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  • 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.

Medical History Questionnaire

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 you have regarding your eye health or vision on the form.

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Hours of Operation

Freeport:

Monday

8:00 am - 6:00 pm

Tuesday

8:00 am - 5:00 pm

Wednesday

8:00 am - 5:00 pm

Thursday

8:00 am - 5:00 pm

Friday

8:00 am - 5:00 pm

Saturday

Closed

Sunday

Closed

Stockton:

Monday

Closed

Tuesday

8:00 am - 1:00 pm

2:00 pm - 5:00 pm

Wednesday

Closed

Thursday

8:00 am - 1:00 pm

2:00 pm - 5:00 pm

Friday

8:00 am - 1:00 pm

2:00 pm - 5:00 pm

Saturday

Closed

Sunday

Closed

Lanark:

Monday

8:00 am - 1:00 pm

2:00 pm - 6:00 pm

Tuesday

Closed

Wednesday

8:00 am - 1:00 pm

2:00 pm - 5:00 pm

Thursday

Closed

Friday

Closed

Saturday

Closed

Sunday

Closed

Oregon:

Monday

Closed

Tuesday

8:00 am - 1:00 pm

2:00 pm - 5:00 pm

Wednesday

8:00 am - 1:00 pm

2:00 pm - 5:00 pm

Thursday

Closed

Friday

8:00 am - 1:00 pm

2:00 pm - 5:00 pm

Saturday

Closed

Sunday

Closed

Rock Falls:

Monday

8:00 am - 5:00 pm

Tuesday

8:00 am - 5:00 pm

Wednesday

8:00 am - 5:00 pm

Thursday

8:00 am - 5:00 pm

Friday

Closed

Saturday

Closed

Sunday

Closed

Freeport:

Monday
8:00 am - 6:00 pm
Tuesday
8:00 am - 5:00 pm
Wednesday
8:00 am - 5:00 pm
Thursday
8:00 am - 5:00 pm
Friday
8:00 am - 5:00 pm
Saturday
Closed
Sunday
Closed

Stockton:

Monday
Closed
Tuesday
8:00 am - 1:00 pm 2:00 pm - 5:00 pm
Wednesday
Closed
Thursday
8:00 am - 1:00 pm 2:00 pm - 5:00 pm
Friday
8:00 am - 1:00 pm 2:00 pm - 5:00 pm
Saturday
Closed
Sunday
Closed

Lanark:

Monday
8:00 am - 1:00 pm 2:00 pm - 6:00 pm
Tuesday
Closed
Wednesday
8:00 am - 1:00 pm 2:00 pm - 5:00 pm
Thursday
Closed
Friday
Closed
Saturday
Closed
Sunday
Closed

Oregon:

Monday
Closed
Tuesday
8:00 am - 1:00 pm 2:00 pm - 5:00 pm
Wednesday
8:00 am - 1:00 pm 2:00 pm - 5:00 pm
Thursday
Closed
Friday
8:00 am - 1:00 pm 2:00 pm - 5:00 pm
Saturday
Closed
Sunday
Closed

Rock Falls:

Monday
8:00 am - 5:00 pm
Tuesday
8:00 am - 5:00 pm
Wednesday
8:00 am - 5:00 pm
Thursday
8:00 am - 5:00 pm
Friday
Closed
Saturday
Closed
Sunday
Closed

Locations

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