Patient Forms

Your smile is forever, and we want to make sure you receive the best and most affordable orthodontic care. You will be in safe hands, treated by a friendly staff and an experienced Board Certified Orthodontist, Dr. Corina Radu. Her specialty is creating beautiful smiles while also addressing other issues related to growth and development, periodontal health, facial balance, jaw surgery, breathing, and sleep disorders.

Please take a minute to fill out this patient medical history form BEFORE your first appointment. Use the BOOK ONLINE widget on the main page to schedule your free consultation.

Should you have dental insurance, please take a front and back picture of your card and text it to us at 630-279-5345. We will use this to do a complimentary insurance benefits check ideally before your free consultation appointment. This will take about 30-45 minutes, depending on how complicated your case is or how many unanswered questions you may have.

Please arrive about ten minutes prior to your consultation so we can verify any information. A parent or guardian must accompany patients under 18 to this consultation appointment. Bring with you, if you have, any referrals or x-rays from your dentist or other specialists if second opinions, ideally taken within the past 6 to 12 months. During your first visit to our office, we will review your medical and dental history, perform a clinical examination, and should we need additional information and you are ready to start on the same day, take diagnostic x-rays and pictures and discuss your treatment options.

 English: 

https://www.orthoii-forms.com/HealthHistory.aspx?culture=en-US&custid=2419

PDF Version: https://www.orthoii-forms.com/OIIHealthHistory.pdf

Spanish:

https://www.orthoii-forms.com/HealthHistory.aspx?culture=es-MX&custid=2419

PDF Version: https://www.orthoii-forms.com/OIIHealthHistorySpanish.pdf

We Offer Affordable Payment Plans

A new smile can boost your confidence, help you get a better job, and even better your relationships. And it's never been more affordable than NOW!   Our payment plans for braces and clear aligners require a $250-$500 down payment, followed by flexible monthly payments extended over the course of your treatment.

We are part of several insurance plans and accept most major credit cards, HSA's  and flex spending accounts. We work hard on your behalf to maximize your insurance benefits. We are by far, the best and most qualified practice to handle your orthodontic and surgical needs,.offering and an inclusive approach and the most flexible financial options around.

We're honored to be trusted with your new smile and pledge to treat you like family!