New Patient Registration Form
Please fill out the following New Patient Registration Form and Dental Consent Form prior to your first visit and present them to the front desk on the day of your appointment to expedite the registration process and avoid any waiting time. The form can also be filled out online and submitted via e-mail to our office.
If you have any questions, please contact our office at 630-243-4554 and a knowledgeable member of our team will be happy to assist you.
We accept most PPO insurance plans and are currently an in-network provider for the following insurances:
Aetna, Ameritas, Blue Cross Blue Shield, CIGNA, Delta Dental, DenteMax Dental, Guardian, Humana, MetLife, United Concordia, and United Healthcare.
If you would like to verify if your insurance is accepted in our office, please call us for more information.
Don't Have Insurance? That's OK!
We have a new, non-insured patient practice membership plan to offer to our patients who are currently not enrolled in a dental insurance plan.
Even without insurance, great dental care is accessible and at an affordable cost. Plans are available for both adults and children. CLICK HERE FOR OUR NON-INSURED PATIENT PLAN.
We accept the following types of payment for services and treatment in our office — CARE CREDIT, VISA, MASTERCARD, and DISCOVER. We also accept CHECKS and CASH. If you have any questions about payment, please do not hesitate to call our office and talk with a member of our team about available financial options.