ACCOUNT & APPOINTMENT INFORMATION
Batavia, IL 60510 • 630.879.7774
St. Charles, IL 60174 • 630.584.6050
beautiful smiles for a lifetime

Forms

Click below to access our forms.

Orthodontic Insurance Information Form

Online Health History Form

General Office Policies Form (PDF)

Treatment Consent Form (PDF)

Privacy Notice Form (PDF)

Acknowledgement of Review of Privacy Practices (PDF)

Photography Release Form (PDF)

General Contest Rules (PDF)

first days in braces »
right age for treatment »
financial & insurance »
137 1st Street
Batavia, IL 60510 • 630.879.7774
403 S. 3rd Street
St. Charles, IL 60174 • 630.584.6050