Lake Zurich New Dental Patients

New Patients

Overview

Your first visit to our practice establishes a vital foundation for our relationship with you. During the first visit, we make sure to obtain important background information and give you time to get to know our staff. To understand what to expect from your first visit to our practice, please read through this page.

Our Mission

Our friendly staff is dedicated to caring for you and your entire family's oral health and well-being. We take the time to create a personalized treatment for each patient and we offer a wide range of services. It is our goal to make your visit with us an extremely pleasant one and to send you home with a beautiful and healthy smile.

Patient Forms

Below is our New Patient Package that you will need to complete on your first visit. You can expedite matters by downloading the package, completing it at home and handing it to our staff when you arrive for your initial visit to our office.

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

What to Expect at Your First Visit

Your first visit to our office is designed to get you better acquainted with all we offer as well as introduce you to our caring staff. On your first visit, we will review your medical and dental histories and evaluate your oral health. We will take digital x-rays of your teeth and explain to you whether or not you will require any dental treatment.

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Thank You!

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Lake Zurich Dentist
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form_button_lock = true; $(form_submit).find('.button.submit[data-dynamic="true"]').text('Sending...'); const appendLocation = $(form_submit).attr('data-append-location') === '1' ? true : false; const locationSelected = $(form_submit).find('select[name="location"] option:selected') ? $(form_submit).find('select[name="location"] option:selected').text() : null; var form_data = {}; var recipients_add = []; var cc_add = []; var db_only = $(form_submit).attr('data-db-only'); var recipients = $(form_submit).attr('data-recipients'); var ad_recipients = $(form_submit).attr('data-ad-recipients'); var cc = $(form_submit).attr('data-cc'); var subject = $(form_submit).attr('data-subject'); var category = $(form_submit).attr('data-category') + (appendLocation && locationSelected ? ` (${locationSelected})` : ''); var is_hipaa = $(form_submit).attr('data-hipaa'); var reply_to = $(form_submit).attr('data-reply-to'); var pdf = $(form_submit).attr('data-pdf'); var submission_url = $(form_submit).attr('data-submission-url'); var ad_source = $(form_submit).find('[data-ad-tracking="source"]').val(); var ad_campaign = $(form_submit).find('[data-ad-tracking="campaign"]').val(); var ad_location = $(form_submit).find('[data-ad-tracking="ad_location"]').val(); var ad_source_key = (get_cookie('source') ? get_cookie('source') : null); var ad_campaign_key = (get_cookie('campaign') ? get_cookie('campaign') : null); var ad_location_key = (get_cookie('location') ? get_cookie('location') : null); $(form_submit).find('input, textarea, select, fieldset').each(function () { if ( $(this).is('input:not([type="file"])') && $(this)[0].hasAttribute('name') && $(this)[0].hasAttribute('data-email-label') ) { value_obj = { 'label': $(this).attr('data-email-label'), 'name': $(this).attr('name'), 'value': $(this).val(), 'type': 'text' }; form_data[$(this).attr('name')] = value_obj; } if ( $(this).is('textarea') && $(this)[0].hasAttribute('name') && $(this)[0].hasAttribute('data-email-label') ) { value_obj = { 'label': $(this).attr('data-email-label'), 'name': $(this).attr('name'), 'value': $(this).val(), 'type': 'textarea' }; form_data[$(this).attr('name')] = value_obj; } if ( $(this).is('select') && $(this)[0].hasAttribute('name') && $(this)[0].hasAttribute('data-email-label') ) { value_obj = { 'label': $(this).attr('data-email-label'), 'name': $(this).attr('name'), 'value': $(this).val(), 'type': 'select' }; form_data[$(this).attr('name')] = value_obj; if ( $(this).find(':selected').length > 0 && $(this).find(':selected')[0].hasAttribute('data-recipients') && $(this).find(':selected').attr('data-recipients').length ) { recipients_add.push($(this).find(':selected').attr('data-recipients')); } if ( $(this).find(':selected').length > 0 && $(this).find(':selected')[0].hasAttribute('data-cc') && $(this).find(':selected').attr('data-cc').length ) { cc_add.push($(this).find(':selected').attr('data-cc')); } } if ( $(this).is('fieldset') && $(this)[0].hasAttribute('name') && $(this)[0].hasAttribute('data-email-label') ) { var val = []; var keys = []; $(this).find('input:checked').each(function () { val.push($(this).attr('value')); keys.push($(this).attr('name')); }); value_obj = { 'label': $(this).attr('data-email-label'), 'name': $(this).attr('name'), 'keys': keys.join('; '), 'value': val.join('; '), 'type': $(this).attr('type') }; form_data[$(this).attr('name')] = value_obj; } }); console.timeEnd('prepare_submission()'); console.time('submit_form()'); resolve({ "form_submit": form_submit, "recaptcha": recaptcha, "form_data": form_data, "db_only": db_only, "recipients": recipients, "recipients_add": recipients_add, "ad_recipients": ad_recipients, "cc": cc, "cc_add": cc_add, "subject": subject, "category": category, "is_hipaa": is_hipaa, "reply_to": reply_to, "pdf": pdf, "ad_source": ad_source, "ad_campaign": ad_campaign, "ad_location": ad_location, "ad_source_key": ad_source_key, "ad_campaign_key": ad_campaign_key, "ad_location_key": ad_location_key, "submission_url": submission_url }) }); } function submit_form(form_submit, recaptcha, form_data, db_only, recipients, recipients_add, ad_recipients, cc, cc_add, subject, category, is_hipaa, reply_to, pdf, ad_source, ad_campaign, ad_location, ad_source_key, ad_campaign_key, ad_location_key, submission_url) { return new Promise((resolve, reject) => { var email_list = []; var first_name = null; var last_name = null; var file_size_total = 0; var files_uploaded = []; var files_selected = 0; if ( form_submit[0].hasAttribute('data-google-conversion') && google_conversion ) { const conversion_code = $(form_submit[0]).attr('data-google-conversion'); if (conversion_code.length > 0) { google_tracking.gtag('event', 'conversion', { 'send_to': conversion_code }); } } if ( form_submit[0].hasAttribute('data-facebook-conversion') && facebook_conversion ) { const conversion_type = $(form_submit[0]).attr('data-facebook-conversion'); if (conversion_type.length > 0) { facebook_tracking.fbq('track', conversion_type); } } $(form_submit).find('input[type="file"]').each(function () { var file_selected = $(this).val(); if (file_selected.length > 0) { files_selected++; } }); $(form_submit).find('input[type="file"]').each(function () { var file_to_upload = $(this).val(); var submit_promise = new Promise((res, rej) => { if (file_to_upload.length > 0) { var xhr = new XMLHttpRequest(); var file = $(this).prop('files')[0]; var formData = new FormData(); formData.append('file', file); xhr.onreadystatechange = function () { if (xhr.readyState == 4) { files_uploaded.push(xhr.responseText); res(xhr.responseText); } } xhr.open('POST', '/system/processors/file_upload/processor.php', true); xhr.send(formData); } else { res('') } }).then((file) => { if (file) { return file; } else { return ''; } }); files_uploaded.push(submit_promise); }); $(form_submit).find('input[type="email"]').each(function () { email_list.push($(this).val()); }); $(form_submit).find('input[type="text"][data-email-label="First Name"]').each(function () { first_name = $(this).val(); }); $(form_submit).find('input[type="text"][data-email-label="Last Name"]').each(function () { last_name = $(this).val(); }); if ((first_name === null || first_name === '') && (last_name === null || last_name === '')) { $(form_submit).find('input[type="text"][data-email-label="Full Name"], input[type="text"][data-email-label="Name"]').each(function () { const full_name = $(this).val(); first_name = full_name; }); } console.time('POST to processor.php') $.post('/system/processors/validation/processor.php', { type: 'date_time', val: null }) .done(function (validation) { console.timeEnd('POST to processor.php') console.time('Wait For Files') Promise.all(files_uploaded).then((value) => { console.timeEnd('Wait For Files') let uploaded_files = value.filter(file => file); console.log(JSON.stringify(uploaded_files)); console.log('Files Uploaded'); console.time('POST to submission_url') $.post(submission_url, { validation: validation, db_only: db_only, recipients: recipients, recipients_add: JSON.stringify(recipients_add), ad_recipients: ad_recipients, recaptcha: recaptcha, cc: cc, cc_add: JSON.stringify(cc_add), subject: subject, category: category, first_name: first_name, last_name: last_name, is_hipaa: is_hipaa, reply_to: reply_to, pdf: pdf, ad_source: ad_source, ad_campaign: ad_campaign, ad_location: ad_location, ad_source_key: ad_source_key, ad_campaign_key: ad_campaign_key, ad_location_key: ad_location_key, files: JSON.stringify(uploaded_files), data: JSON.stringify(form_data), email_list: JSON.stringify(email_list) }) .done(function (data) { console.timeEnd('POST to submission_url') form_button_lock = false; form_submit[0].reset(); $(form_submit).find('.remove_file').click(); $('form .button.submit[data-dynamic="true"]').each(function () { var placeholder = $(this).attr('placeholder'); $(this).text(placeholder); }); if ($(form_submit).attr('data-action') !== '') { var action = $(form_submit).attr('data-action'); if (action == 'close_lightbox') { close_lightbox(); } if (action == 'redirect') { var redirect = $(form_submit).attr('data-confirmation'); window.location.replace(redirect); } if (action == 'function') { var form_complete_function = $(form_submit).attr('data-confirmation'); window[form_complete_function](form_data); } if (action == 'none') { } } else { var confirmation = $(form_submit).children('section[data-type="system-lightbox-content"]'); $(confirmation).clone().appendTo('section[data-type="system-lightbox-container"]'); open_lightbox(); } resolve(false); }); }); }); }); } function get_viewport_size() { viewport_size = viewport(); $('body').attr('data-width', viewport_size.width); $('body').attr('data-height', viewport_size.height); } function viewport() { var e = window, a = 'inner'; if (!('innerWidth' in window)) { a = 'client'; e = document.documentElement || document.body; } return { width: e[a + 'Width'], height: e[a + 'Height'] }; } function set_tracking() { const url_parameters = new URLSearchParams(window.location.search); const source = url_parameters.get('source'); const campaign = url_parameters.get('campaign'); const location = url_parameters.get('location'); if (source) { set_cookie('source', source, 90, null); } if (campaign) { set_cookie('campaign', campaign, 90, null); } if (location) { set_cookie('location', location, 90, null); } } function load_functions() { javascript.load.forEach(function (v) { javascript.prototype[v](); }); } function load_fa() { /* $.getScript('https://kit.fontawesome.com/10cd9403cd.js'); */ } function load_default_subs() { $('video:not(.no_subs)').each(function () { var found_video = $(this); if ($(this).find('source').length) { var video_source = $(this).find('source').attr('src').split('/').pop(); } else { var video_source = $(this).attr('src').split('/').pop(); } $.get('/custom/content/subs/' + video_source + '.vtt', function (data) { if (data === 'Error') { $('') .attr('label', 'English') .attr('kind', 'subtitles') .attr('srclang', 'en') .attr('src', '/system/content/subs/no_audio.vtt') .appendTo(found_video); } else { $('') .attr('label', 'English') .attr('kind', 'subtitles') .attr('srclang', 'en') .attr('src', '/custom/content/subs/' + video_source + '.vtt') .appendTo(found_video); } }) .fail(function (data) { $('') .attr('label', 'English') .attr('kind', 'subtitles') .attr('srclang', 'en') .attr('src', '/system/content/subs/no_audio.vtt') .appendTo(found_video); }); }); } function stalling(ms) { return setTimeout(() => { }, ms); } function initialize() { window_width = $(window).width(); window_height = $(window).height(); get_viewport_size(); viewport_size = viewport(); update_deferred_images(); set_resize_listeners(); set_scroll_listeners(); set_accordion_listeners(); form_actions(); set_tracking(); load_functions(); load_fa(); load_default_subs(); track_load(); deferred_websocket(); lazy_load_deferred_images(); // Add Tracking to each button const selection = document.querySelectorAll('section[class^="section_"], #di-consent-banner, #di-cookie-pref-dialog'); for (var i = 0; i < selection.length; i++) { var found_buttons = selection[i].querySelectorAll("a[href], [data-click-tracking]:not(a[href]), button:not(a[href])"); found_buttons = Array.from(new Set(found_buttons)); found_buttons.forEach(element => { element.addEventListener('click', function (e) { var stall = false; if (this.tagName === 'A' && this.getAttribute('href') !== '#') { stall = stalling(500); } track_click(this).then(() => { if (stall !== false) { clearTimeout(stall); } }) }) }); } } $(document).ready(initialize);