$1 Exam, X-Rays and Sonic Toothbrush

DentalWorks Schaumburg

1320 E . American Lane

Schaumburg, IL 60173

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New Patient Forms

Get a head start on your appointment.

New Patients –

Please complete and print the Health History and Payment Arrangement forms available at the link below. Bring the completed forms to your first appointment. Don't forget to arrive 15 minutes prior to your scheduled appointment time.

Existing Patients –

If your contact, health history and/or insurance information has changed, please complete and print the forms, and bring them to your next scheduled appointment.

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