Patient Forms

In preparation for your child’s dental appointments, we have the following forms available to download in PDF format. You may then print them from your home computer. Please complete the paper forms at home and either bring them with you at your appointment time or fax them to us at (630) 858-6204.

New Patients/New Family

Please complete one form for each child.

Current Patient Families

If you are adding another child as a patient, please complete provide their health history for the first check-up.

Current Patients

Helpful forms for our current patients.

Transferring Patient


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*These forms require Adobe Acrobat Reader. Click the Adobe logo above to download.