Forms and financing for Schaumburg, IL.
Download your new patient paperwork, check whether we are in network with your dental plan, and see the payment options we offer if you do not have insurance.
Visit
435 S Roselle Rd, Schaumburg, IL 60193Call
(224) 459-1270Hours
Mon and Tue 10 to 6, Wed 7 to 3, Thu and Fri 8 to 2, Sat and Sun 8 to 1
Download Forms
New Patient Forms
Complete our new patient paperwork online before your first appointment. It saves time at check-in and helps our team prepare for your visit.
Do you take my insurance?
We are in network with most major PPO dental insurance plans, and we file claims on your behalf so you do not have to chase paperwork. Call us with your plan details and we will confirm your coverage before you book.
Plans we are in network with
- Aetna
- Ameritas
- Cigna
- MetLife
- GEHA
- Guardian
- Humana
- Principal
- Sun Life
- United Concordia
Plans we cannot bill
- Medicaid and All Kids
- HMO plans
- DMO plans
Dental Benefits Sheet
A short guide to how dental benefits work, what your plan usually covers, and the terms you will see on a claim.
$229: exam, digital X-rays, cleaning and treatment consultation.
More for patients: what happens at a first visit or return to the For Patients hub.
Sort the paperwork, then come see us.
Send your plan details ahead of time and we will confirm your coverage before your appointment.
● Open Saturday and Sunday, 8:00 am – 1:00 pm. Weekday appointments are available too.
435 S Roselle Rd, Schaumburg, IL 60193(224) 459-1270| Monday | 10:00 am – 6:00 pm |
|---|---|
| Tuesday | 10:00 am – 6:00 pm |
| Wednesday | 7:00 am – 3:00 pm |
| Thursday | 8:00 am – 2:00 pm |
| Friday | 8:00 am – 2:00 pm |
| Saturday | 8:00 am – 1:00 pm |
| Sunday | 8:00 am – 1:00 pm |