Are you a new patient to our Mt. Prospect dentist office? Are you preparing to have an extraction, endodontic treatment, or another type of treatment at our clinic? If so, there are a few forms that you will need to complete before you receive our dental services. These forms contain important information in them to help you better understand the treatment you are about to receive, and they provide us with important patient information that we need for our records. Please find the appropriate form for your needs below, complete it, and bring it with you to your appointment. If you have any questions, please contact our dentist office for assistance.

Euclid Smiles Family Dental Forms

New Patient Registration Form

Acknowledgment Privacy Practices – English

Acknowledgment Privacy Practices – Spanish

Notice Privacy Practices – English

Notice Privacy Practices – Spanish

Informed Consent for Chairside Tooth Whitening Treatment

Endodontic Consent – English

Endodontic Consent – Spanish

Extraction Consent – English

Extraction Consent – Spanish

Nitrous Oxide

Oxido Nitroso