Here’s What You Need to Know!
New Patient Forms
We are so glad that you decided to become part of our dental family. Below are the forms that you will need to fill out and bring with you to your first visit or feel free to fill them out on one of our office iPads once you arrive.
- Patient Registration – PDF
- Medical History – PDF
- Financial Policy – PDF
- HIPAA Authorization – PDF
“This feels great!” We hear that a lot when patients experience our comfortable dental chairs, soothing warm towels, blankets and neck pillows.
You can tune out and relax with wireless headphones for music, Netflix TV and Movies, or surf the web on one of our iPads. We can speak Russian and Spanish in addition to English in our office.
Every treatment room is equipped with the latest in modern technology, so every digital photo and image we take of your mouth, you can view at the same time we do!
We also offer Caesy Patient Education videos where you can listen and watch videos that explain different procedures. They’re available in English or Spanish.
Additionally, our office is completely paperless. All forms and documents are provided electronically via an iPad. It is just another way we try to make your experience as simple as possible.
At Long Grove Dental Studio, we offer a variety of payment options:
- We are in network with most insurance plans. Contact us at to talk to us about your plan.
- If not insured, please talk to us and we can discuss other options with you. We accept checks, most major credit cards, and third-party financing through Care Credit.
- We also now offer our very own membership-based Dental Savings Plan as cost-saving alternative to those without insurance. For more information, click the Smile Advantage graphic.