(815) 255-3223  

Patient Forms

New Patients

Click below to log in to your account. Here you can check your appointments, make payments online, etc.

New Patient Login


Current Patients

Make An Appointment

SMILE SAVINGS PLAN

Looking for a better alternative to dental insurance? We have the solution.

Our Smile Savings Plan allows individuals to receive routine dental services, additional benefits and exclusive discounts for a low annual fee!

• NO Yearly Maximums   • NO Deductibles   • NO Claim or Pre-Authorization Forms
• NO Waiting Periods   • Call Now to Join Our Smile Savings Program Today!


Click here to easily make your payments with Care Credit! »  


Referral Program

One of the highest compliments a dental practice can receive is when a patient refers a friend, co-worker or relative. We have made this process simple and easy by providing the form below. We guarantee they will receive the same high quality of care you have come to expect from us.

Patient Referrals

The form below will send an email to your friend. We will only contact them if they respond saying that they would like more information about our office.