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(630) 571-3030

Serving Oak Brook and the West Suburbs

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Patient Center

Welcome to our patient center! Here you will find many of our patient forms available for download. Our goal is to make your experience with us as seamless and enjoyable as possible. Please feel free to fill out the appropriate forms before your visit, by acquiring them here and bringing them in to the office. If you are not sure which forms you need prior to your visit, please contact our office during normal business hours, and we will be more than happy to assist you.

We have also provided many post visit instruction forms, in case you need to reference them again.

New Patient Forms

West Suburban Family Dental offers our patient form(s) online so they can be completed in the convenience of your own home or office. Follow these easy three steps:

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Bring them with you to your appointment.

Please print and fill out forms 1 and 2 below. Along with the completed forms, please bring a photo ID and your dental insurance information to your scheduled appointment so that we may make a copy for our records.

  1. Patient Welcome and Health History Form
  2. HIPAA Notice of Privacy Practices

*​ HIPAA Notice of Privacy Practices

* Patient Acknowledgements, Agreements & Authorizations

* You do not need to print and bring these forms to our office. These forms are for your records only.


Current Patient Instruction Forms


Complimentary Consultation

Why Choose Us?

What Makes Us Different

  • Practicing Since 1994
  • Utilizing the Latest in Technology & 3D Imaging
AAID Graduate of USDI ADA Member
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