1711 South Neil Street Champaign, IL 61820
(217) 359-2390 Email

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

Revolution PHR


Payment Options

At Jones Optical, 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

Medical Insurance

  • Aetna
  • Blue Cross Blue Shield
  • Coventry Health Care
  • Cunningham Township
  • Health Alliance
  • Medicaid
  • Medicare
  • United HealthCare

Vision Plans

  • EyeMed
  • Vision Service Plan

Our practice accepts most insurance plans. Coverage may vary from one plan to the next. Please call our office at (217) 359-2390 to verify your benefits before your visit.