Call Us Today! Macomb 309-833-3500
Avon 309-465-3165

New Patient Forms

Please print out the form below, fill out, and bring it to your first appointment. Thank you and we are looking forward to seeing you soon.

Click Here to Download Consent Form

Click Here to Download Medical History Form

Click Here to Download Patient Financial Agreement

Click Here to Download Release of Dental Information

Contact us today to schedule an appointment