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Dentalife
Reservations

Reserve Your Time with Us
We are delighted to welcome you to our practice and are pleased that you chose us to serve your dental needs. We are serious about providing superior dental care and proud of our dedication to our family of patients. Our goal is to help you reach your goals for your mouth, teeth, gums and smile by providing excellent dental care.

To facilitate being seen just as soon as possible at the time of your reservation, we would appreciate it if you would download the following documents and bring them with you to your reservation. We reserve your time specifically for you and the doctor.

As a courtesy to our patients, we file your primary dental insurance for you. At the time of the reservation, any deductible or co-pay is due in the form of cash, check, Visa/MasterCard, Discover or American Express. We have also partnered with two outside financing companies, CareCredit and Chase Health Financial for investments over $1000.

Care Credit Logo Chase

Just complete the following form and one of our team members will contact you as soon as possible to schedule a convenient time for your first appointment.

Please provide the following contact information. Bold fieldnames indicate required information.

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Referred By
(Mrs. Jones)

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Wheaton Cosmetic Dentistry | 1275 East Butterfield Road, Suite 202 | Wheaton, IL 60187 | (630) 653-5152