COVID-19 Update from Retina Consultants, Ltd.
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Forms and Documents

Retina Consultants, Ltd. Contents Patient Info Forms and Documents

 

New Patient Forms:

  1. New Patient Forms
  2. New Patient Privacy HIPAA Forms

 

Release Forms:

  1. Email Records Release Form
  2. Medical Records Release Form FROM RCLTD
  3. Medical Records Release Form TO RCLTD
What we offer

Services

Our Locations

Choose your preferred location

2454 E Dempster St Suite 400, Des Plaines, IL 60016
847-299-0700
755 S Milwaukee Ave Suite 263, Libertyville, IL 60048
847-299-0700
2250 Point Blvd Suite 120, Elgin, IL 60123
847-299-0700
3100 Ogden Ave, Lisle, IL 60532
847-299-0700
7667 W 95th St Suite 103, Hickory Hills, IL 60457
847-299-0700
5225 Old Orchard Road Suite 25B, Southeast corner of the building, Skokie, IL 60077
847-299-0700
5215 N. California Ave Ste F717, Inside the Foster Medical Pavilion, Chicago, IL 60625
847-299-0700