Patient Portal & Forms

4Sight iCare is pleased to offer you convenient, secure access to information from your eye care record through our online patient portal called RevolutionPHR (Personal Health Record).

RevolutionPHR utilizes the highest standards of online security while allowing you access to all your useful information.  Use of this powerful online portal to access the following: 

  • BOOK/CONFIRM APPOINTMENTS ONLINE, LIVE!
  • UPDATE YOUR FAMILY’S DEMOGRAPHIC INFORMATION
  • CHECK THE STATUS OF YOUR GLASSES/CONTACT LENS ORDERS
  • VIEW & PRINT ACCOUNT INVOICES; SEE REMAINING BALANCES/CREDITS
  • 4 Easy Steps to Gain Access to RevolutionPHR

    1. Access the Patient Portal using the button below.
    2. Insert the email address you provided at your eye exam as your “Username” and click “Submit”. 
    3. In your email inbox, click the link sent to you by RevolutionPHR.
    4. Enter your choice of password: it must be at least 8 characters and include at least one number and one capital letter.

    Access the Patient Portal

    Now you have online access to your entire eye health record; just log in with your new login credentials (email and password).

    Enjoy, and don’t forget to invite your friends and family to share in this online experience that keeps you in touch with your eye doctor’s office!

    Should you have any questions please contact us via text or phone at  (815) 676-4474

    We genuinely hope that you find value in this secure, convenient access to all your eye care information.



Patient Forms

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.

Dynamic Electronic Exam Form - Get Started!

Physical forms may be needed for your appointment. Please download, print, fill out, and bring the relevant forms or contact us for more info!

New Patient Paperwork - Download & Print

Established Patient Paperwork - Download & Print

Skip the Line at the DMV with a Vision Specialist Report - Download & Print

Back to School Eye Exam Report - Download & Print

Annual Policy Form - Download & Print

Hours of Operation

Monday

Closed

Tuesday

12:00 pm - 8:00 pm

Wednesday

10:00 am - 6:00 pm

Thursday

10:00 am - 6:00 pm

Friday

10:00 am - 6:00 pm

Saturday

9:00 am - 2:00 pm

Sunday

Closed

Monday
Closed
Tuesday
12:00 pm - 8:00 pm
Wednesday
10:00 am - 6:00 pm
Thursday
10:00 am - 6:00 pm
Friday
10:00 am - 6:00 pm
Saturday
9:00 am - 2:00 pm
Sunday
Closed

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