Online Forms

patient forms Belleville, IL
It is always our goal at Dr. Becherer & Associates, Ltd. to give you the eye care you deserve in a timely manner. In order to ensure that your first visit goes smoothly, you may want to complete the forms below prior to your visit. You can even fax us your forms or drop them off prior to your appointment to speed up your first visit.

Assignment of Benefits Form – Download & Print Form | Online

Welcome Form – Download & Print Form | Online

Before your Appointment – Download & Print Form | Online

If you do not have AdobeReader® installed on your computer, Click Here To Download.

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Our goal is for you to leave our office with a memorable and enjoyable experience, which is why our welcoming and compassionate staff will do everything they can to make you feel right at home.

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