The eye surgeons, doctors and staff at Kovach Eye Institute are dedicated to providing patients with the highest quality of comprehensive medical eye care by remaining on the forefront of Ophthalmic technological advancements. Kovach Eye Institute is committed to giving patients an informed and comfortable experience throughout their journey to attaining the best quality of vision possible. Our doctors are proudly supported by highly trained clinical and administrative staff, devoted to providing the highest support to patients. We would like to provide you with resources such as online registration, pertinent patient forms, medical forms and records, insurance information, and billing information. Please explore this section for any patient resources you may require.
Thank you for taking time to fill out this pre-registration form. We are trying to reduce patient wait time when checking in.
Download Patient Forms:
Authorization Release of Medical Records
How to Request Medical Records
To obtain copies of your medical record, please download and complete the Authorization for Release of Medical Records. You must provide your signature; no E-signature or E-sign are allowed.
You may fax completed form to 630-833-9465 or Mail completed forms to:
Kovach Eye Institute
Attn: Medical Records
152 N. Addison Avenue
Elmhurst, IL 60126
To have a copy of your medical records sent to Kovach Eye Institute from another facility, please contact that provider directly. For questions, please call 630-833-9621, Monday through Friday, 8AM – 5PM
There are no fees associated with requests for information.
Records requested by the patient can be sent securely via e-mail, picked up at 152 N. Addison Avenue, Elmhurst, IL, or mailed to an address specified. Please indicate your preferred delivery method when making your request. Please allow 7 to 14 business days for delivery from the date of the request.