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Patient Info

New Patient Forms

Click below to download a printable copy of our health history form to save some time on  your first appointment. Print it out and complete it at your convenience prior to your first appointment.

No printer? No problem!  We have plenty of these forms available for you at the office. We recommend coming to your first appointment 10-15 minutes early to give you enough time to fill out our health history form. We look forward to seeing you soon!

New Patient Forms
Dental Exam Form

Illinois School Proof of Dental Exam Form

Healthy mouths mean children can spend less time in pain and at the dentist and more time learning and playing. Most schools in Illinois require annual dental exams for enrolled children.  We offer free exams for school-aged children who need exams for school. Click below to download a copy of the State of Illinois Proof of School Dental Examination Form.



We currently accept plans from the following insurance companies.  It's always a good idea to call us to make sure we accept your plan before your appointment!

  • Delta Dental

  • Met Life

  • Cigna

  • Blue Cross Blue Shield

Unfortunately, we do not accept state insurance at this time.

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