Registration
New Patients
YOUR INITIAL VISIT
Your initial visit will include meeting with the doctor, examination of teeth, evaluation of existing dental work, a check of the health status of your gums, oral cancer screening and a full set of diagnostic x-rays. With digital X-rays and intra-oral camera tour, you will see your own teeth and the inside of your mouth magnified on a flat screen. You will be amazed!
We will talk about prevention of disease, proper treatment of current problems and possible enhancements to your smile. Together, we'll come up with an action plan clinically and financially to best meet your desires and needs for a healthy, beautiful smile for lifetime. If your treatment plan calls for a regular hygiene appointment, we will do just that. You'll love the way your teeth will feel.
Our office is currently accepting new patients.
Please call our dedicated New Patient Line at 815.356.0030 to schedule your appointment.
Patient Forms
We have made the new patient registration process easier for you.
There are three sets of forms --
- Consent for Internet Communications
- Medical & Dental History Form
- New Patient Registration Form
Please fill out these forms and SUBMIT them online prior to your first visit. With Online Registration, there is no paperwork (and hence less carbon footprint!) and you can do it at your own convenience. So when you arrive at your office, we can see you immediately and you can feel better about your contribution towards our environment at the same time!
Click here to fill out New Patient Registration forms online.
- Request for Release of Records to Us
- Request for Release of Records from Us
INSURANCE & PAYMENTS
We accept most insurances and their assignments. As a courtesy and value-add to our esteemed patients, we submit all insurance claims and do any follow-up that is needed. We do as thorough research of your benefits as allowed by your insurance. We do our best to accurately inform you about your insurance benefits and payments. Our claims are submitted electronically to speed processing and minimize delay.
We are a fee for service dental practice. We work directly for our patients. We are not a 'Preferred Provider' for any insurance company. So when you come to our office, we service you directly. This helps us keep our patients' interests always ahead of any other considerations.
Payments are expected at the time of service. We accept cash, personal check, MasterCard, Visa, Discover and American Express. In addition, we will gladly arrange convenient payment plans and third party loans if needed.
If you have any questions about your insurance plans and payment options, give us a call. We will be happy to assist you.
What Does It Mean If a Dentist Is “In Network”?
Many dentists are “in network” with certain dental benefit plans. This means these dentists (also known as participating dentists) have signed a contract with the dental plan carrier agreeing to accept that plan’s set fees as payment for services. A part of the agreed-upon fee is paid by the carrier, and you often pay a portion of it with your deductible and co-insurance for the plan.
What Does It Mean If a Dentist Is Not “In Network”?
While dental plan carriers may encourage you to see a network dentist, your choice of dentist should depend more on how well the dentist fits your dental care needs than how it fits your dental plan. You may prefer a dentist that is not in your plan’s network.
Read your plan carefully to see if it restricts you to seeing a network dentist, and check with your preferred dentist’s office about how your plan would work with his or her office. Capitation programs (which include dental health maintenance organization (DHMO) plans) and some highly restrictive PPO plans (known as exclusive provider organization [EPO] plans) do not provide any benefit coverage for treatment by "non-participating" dentists. There are, however, plans that allow you the right and freedom to choose your own preferred dentist.
Financing Your Treatment
Dr Agnes is awesome! I used to fear dentists with my whole body and be so afraid that I would bring on my own anxiety attacks. She and her staff try so hard not to cause pain if there is anything they can do. I’m no longer afraid and if easy I am she’d assured me that it won’t. Thanks so much Dr AgnesTheresa N.