Patient Center

Online Forms

Speed up your visit by completing the necessary form(s) below. For your convenience, you can either fill the form(s) out online or download and print the form(s) and bring it with you to your appointment.

Patient Information Form - Submit Online | Download & Print


Payment Options

At Burgwald Eye Center, our mission is to provide quality service and products at reasonable pricing. We accept the following payment methods:

  • Cash
  • Check
  • Visa, MasterCard, American Express, and Discover
  • Flexible Spending Plans
  • Health Savings Accounts (HSA)
  • CareCredit

Participating Insurances

Medical Plans

  • United Health Care
  • Health Link
  • Blue Cross Blue Shield
  • Personal Care
  • Health Alliance (with the exception of Medicare Advantage Plan)
  • Medicaid and All Kids

Vision Plans

  • EyeMed
  • Vision Service Plan (VSP)

Our practice accepts most insurance plans. Coverage may vary from one plan to the next. Please call our office at 217.586.1726 to verify your benefits before your visit.