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Patient Forms (PDF Format):

Our forms are in the PDF format which requires Adobe Reader 9 to open.  If you experience any problems with the forms opening click here for the latest free version of Adobe Reader.




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New Patient Form (Print - Complete by Hand)
Save time during your initial visit by completing the New Patient Information Form prior to your visit.




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Office Financial Policy Form
You can add a description in this area about your PDF file including some details or options. You will then change the links on this page to link to your PDF files.




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HIPPA Policy Form






Lakeland Hills Dental Office
Our Dental Office in Fairview Heights, IL.


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