New Patients
At your first appointment, our caring and friendly office staff will welcome you and ensure that your visit at Advanced Family Dental & Orthodontics is as comfortable and enjoyable as possible.
If you have fear or anxiety about visiting the dentist, we will do our best to alleviate any concerns you may have. Our dentists and staff are great at explaining what needs to be done and how it relates to your oral health and overall health.
Your confidence in our care is our most important priority. We have the best patients!
Patient Forms
Save time at the office by downloading and filling out our patient forms by clicking the links below:
- Adult (502 KB)
- Child (99 KB)
- Orthodontic (155 KB)
- Financial Policy (Crest Hill) (140 KB)
- Financial Policy (Frankfort) (140 KB)
- Financial Policy (Shorewood) (140 KB)
- Financial Policy (Lockport) (140 KB)
- Acknowledgment of Receipt of Privacy Practices (46 KB)
- HIPAA Patient Consent/Acknowledgement Form (32 KB)
- Notice of Privacy Practices (48 KB)
- COVID Consent Form (Crest Hill) (86 KB)
- COVID Consent Form (Crest Hill Orthodontics)(86 KB)
- COVID Consent Form (Frankfort) (86 KB)
- COVID Consent Form (Lockport) (86 KB)
- COVID Consent Form (Shorewood) (86 KB)
- Automated Communication Consent Form (86 KB)
- Insurance Information (25 KB)
- Credit Card on File Consent (99 KB)
Formas de Pacientes en Español
Ahorre tiempo en la oficina descargando y completando nuestros formularios para pacientes haciendo clic en los siguientes enlaces:
- Adulto (464 KB)
- Niño (64 KB)
- Política Financiera (Shorewood Illinois) (100 KB)
- Política Financiera (Frankfort Illinois) (100 KB)
- Política Financiera (Lockport Illinois) (100 KB)
- Política Financiera (Crest Hill Illinois) (100 KB)
- Formulario de Autorización de la Tarjeta de Crédito (97 KB)
- Información del Seguro (43 KB)
- Formulario de consentimiento de comunicación automatizada (139 KB)