Patient Forms, Map and Directions to Chicago Office
Your first visit to More Smiles of Beverly involves a few special steps so that we can get to know you. To understand what to expect, please read through this page. You'll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more. There's also background information about our committed staff and our first visit procedures. You can also save some time by printing out and completing the patient forms in advance of your appointment.
Our purpose is to glorify our Creator thus producing happy clients, staff and trainees who repeat and refer others in a thriving environment where the company can continue to invest in our clients, staff and trainees.
We endeavor to increase the oral hygiene of the community we service by free consultations, education, referrals and working with insurance companies to help people have a healthy smile. Poor dental hygiene affects all body systems negatively and it is the goal of More Smiles of Beverly to prevent and restore the mouth to a healthy status in a pain and stress-free environment, and thus puts the patient at ease.
More Smiles of Beverly wants patients, staff and trainees to feel at home with a newly designed office, which includes personal touches such as specially designed rooms, television, coffee and condiments served to individual taste, soft music and more.
To fulfill this mission, we are committed to:
- Listening to those we are privileged to serve.
- Earn the trust and respect of patients, profession and community.
- Exceed your expectations.
- Ensure a creative, challenging and compassionate professional environment.
- Strive for continuous improvement at all levels.
Please fill out these forms online, or print and fill out these forms so we can expedite your first visit:
- Patient Registration Forms [ Online ] [ PDF ]
- Financial Policy [ Online ] [ PDF ]
- HIPAA [ Online ] [ PDF ]
- Consent Form [ Online ] [ PDF ]
- COVID 19 Questionnaire for Dental Practices [ Online ] [ PDF ]
- Patient Advisory and Acknowledgment [ Online ] [ PDF ]
- Referral Form
- Medical Clearance for Dental Treatment
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
What To Expect
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It also will help relieve any unnecessary anxiety you may be feeling. Educate yourself on your symptoms by reviewing the content on this Web site. Also, take some time to review our staff page and familiarize yourself with the doctors. We look forward to your first visit!