Schedule an Appointment

Please complete the form below and someone from our office will contact you shortly to confirm your appointment date and time. Please be aware that you are submitting a request only. Until a representative from our office has contacted you, you do not have an actual appointment.

We cannot schedule a "same day appointment" via this website, however, same day appointments may often be available. Please call the IEC office nearest you if you are interested in an appointment today. (For Lasik Consultations: Contact lens wearers must leave lenses out for a period of time prior to appointment. Our patient service representative will go over details).

You may also call TOLL FREE 877-457-6485 between 8:30am - 5:00pm, Monday through Friday to schedule an appointment for ANY OFFICE.

Note: All required fields are marked *

*Name
Address
City
State
Zip Code
*E-Mail:
*Confirm E-Mail:
*Daytime Phone
Evening Phone
*Best way to contact
Date of Birth - mm/dd/yy
*Preferred day for appointment
*Preferred appointment time
*Location for appointment
*Type of visit	If reason unlisted, fill out the "Other" field below.
Other:
Vision Insurance

NEW PATIENT FORM

If you have already scheduled your new patient exam and havereceived confirmation of date and time of appointment, please print these forms, fill out completely and bring with you to your appointment. PATIENT FORMS.

LASIK CONSULTATION appointments use LASIK FORMS.

Download and Print Forms
To view and print forms you will need Adobe Reader which can be downloaded for free by clicking on the icon below.

Schedule your Eye Doctor (Optometry) Appointment in Illinois (Quincy, Jacksonville, Pittsfield) and Missouri (Kirksville, Hannibal and Mexico)

Lasik Eye Correction Surgery in Illinois (Quincy, Jacksonville, Pittsfield) and Missouri (Kirksville, Hannibal and Mexico)