New Patient Forms

Please print, sign and bring the following New Patient forms to your child’s first visit:

•Child Health History

In addition to this online form, please print, sign and bring the following Policy Forms with you on your 1st visit to our office:

•Pediatric Informed Consent

•Office Policies

•HIPPA Policy

New Patient Forms


The Naperville & Shorewood Pediatric Dentists at Innovative Pediatric Dentistry provide care for the Chicago, Illinois metro area including Aurora, Batavia, Bolingbrook, Burr Ridge, Downers Grove, Geneva, Glen Ellyn, Hindsdale, Joliet, Lemont, Lisle, Lockport, Minooka, Naperville, Oak Brook, Ottawa, Plainfield, Shorewood, Spring Valley, St Charles, Western Springs, Wheaton, and Woodridge areas.

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