Patient Online forms

Prior to scheduling a first appointment we ask that you complete a New Patient Form and return to our office so we can create your patient record in our system. You can download and print our New Patient Form below or call our office and we can send you a link to an online fillable form you can complete on your phone or computer. You can reach us at at 224 654-6543.

Patient Information Forms:

• New Patient Form

Patient Home Instructions:

• X-ray Use and Child Safety
• Soft Diet Instructions
• Preparing Your Child for Treatment
• Post Trauma Instructions
• Post-Extraction Instructions
• Pacifier Chart
• About Nitrous Oxide
• Toothbrush Calendar
• Flossing Chart
• About Canker Sores