Dental Specialists of
South Loop

Patient Registration

checkbox-form1Now you can complete patient information and medical history information from the comfort of your own home. Please select a form from the menu below. After the form is submitted, we’ll contact you in the next few days. There is also an option to print the forms from your home printer if you choose to do so.  Thank You.

Online Registration Form

Patient Registration PDF

Medical History PDF

Your Smile. Your Health. Our Commitment.

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South Loop Dental Specialists

850 South Wabash, Suite 240
Chicago, IL 60605