Patient Forms — Loukas Dentistry, Park Ridge, IL
Save time at your first visit by completing your patient forms in advance. Our new patient paperwork covers your health history, insurance information, and consent forms. You can fill them out at home and bring them to your appointment, or arrive 15 minutes early to complete them in our office.
New Patient Registration
Please complete the New Patient Registration form before your first visit. This form collects your personal information, dental history, insurance details, and any health conditions that may affect your dental care.
Health History Questionnaire
Your health history is an important part of your dental care. Please complete the Health History Questionnaire honestly and thoroughly. Let us know about any medications, allergies, or medical conditions you have.
Questions?
If you have any questions about our forms or your upcoming appointment, please call us at (847) 696-1919 or visit us at 714 W Higgins Rd, Park Ridge, IL 60068.

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