Downloadable Forms

Downloadable Forms in La Grange, IL

Feel free to download the forms you need right from our website! These forms are in PDF format and require a PDF reader such as Adobe Acrobat (Windows) or Apple Preview (Macintosh).

Financial Policy

HIPAA

Medical History

Notice of Privacy Practices

Patient Registration

Sign up for a free consultation!

La Grange Dental Associates
4711 Willow Springs Road La Grange IL 60525
1-708-354-1990 1-708-354-2646 USD Cash, Check, MasterCard, Visa, American Express, Most Dental Insurance Plans, CareCredit, Lending Club Patient Solutions, Prosper Healthcare Lending
Joseph Balice Doctor
John Micaletti Doctor
Deanna Registered Dental Hygienists
Lisa Registered Dental Hygienists