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Great Smiles Dental CenterGreat Smiles Dental
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Call Us Today (773) 588-4650

HomePatient Forms

  • Cosmetic Dentistry

  • Shock Bright Teeth Whitening
  • Dental Bonding
  • Dental Bridges
  • Dental Crowns
  • Dental Implants
  • Porcelain Dental Veneers
  • Invisalign
  • General Dentistry

  • Composite Fillings
  • Dental Sealants
  • Dentures
  • Pediatric Dentist
  • Periodontal Scaling
  • Root Canal
  • Teeth Cleaning
  • Tooth Extraction

Download any of the forms below, and please have them filled out when you come to your dental appointment.

  • Welcome Sheet
  • Patient Registration
  • HIPAA Privacy Form
  • HIPAA Acknowledgement Form
  • Smile Analysis
  • ViziLite Waiver
  • Invisalign Consent Form
  • Spanish Welcome Form
  • Spanish Medical History

Office Hours

Monday – By appointment only
Tuesday – 9:30am – 7:00pm
Wednesday – 9:30am – 7:00pm
Thursday – 9:30am – 7:00pm
Friday – 10:00am – 6:00 pm
Saturday – 10:00am – 4:00pm

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Call Today

(773) 588-4650

Great Smiles Dental Center

3451 W. Irving Park Rd
Chicago, IL 60618

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