New Patient Forms

Please prepare for your first appointment by completing our new patient information forms. Download the forms to your computer to complete at home and then please bring them with you to your first appointment.

You may access the following forms to assist us with your care. Please print and fill out the following forms, then bring them to your appointment.

Adult Medical Dental History Form - PDF Under 18 Medical Dental History Form - PDF
New patient forms
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PATIENT TESTIMONIALS

GLEN CARBON

23 Glen Ed Professional Park

(618) 692-1044
VANDALIA

2219 W Randolph Street

(618) 692-1044

After careful consideration, we have decided to merge both the Granite City and Glen Carbon practices. By combining the two offices we are making a commitment to provide ALL of our patients with the highest technological advancements available for the treatment of orthodontics.