Care Credit
Patient Portal
New Patient Journal

Making your visit smooth

For your convenience

For you convenience please fill out these forms before your visit to help save you valuable time.

 

 

Medical & Dental History

Please print out the following pdf form, fill it out and bring it to your appointment to speed up the check in time.

Medical & Dental History Form

Patient Info
Form

Please print out the following pdf form, fill it out and bring it to your appointment to speed up the check in time.

Patient Information Form

Financial Policy Form

Please print out the following pdf form, fill it out and bring it to your appointment to speed up the check in time.

Financial Policy Form

HIPAA
2021
Form

Please print out the following pdf form, fill it out and bring it to your appointment to speed up the check in time.

HiPAA 2021 Compliance Form
Our Professional Staff and State-of-the-Art Tecgnology

Create healthy, strong and beautiful smiles

  • Costmetic Dentistry
  • Remake Veneers in 2 easy visits
  • Fillings with Natural looking tooth color
  • Strong Beautiful Crowns in one visit

Get In Touch

Location: 1840 1st Ave., Sterling IL 61081

Telephone: (815) 625-2532

Fax: (815) 625-2561

Email: [email protected]

Hours: M-Th: 8am – 5pm

Contact Us
Privacy Policy

We are required by applicable federal and state law to maintain the privacy of your health information. We are also required to give you this Notice about our privacy practices, our legal duties, and your rights concerning your health information. We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect April 14, 2003, and will remain in effect until we replace it. Read Entire Privacy Policy Here.