Smile Gallery
 

The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time, you will save a significant amount of time during your visit. Please be prepared to provide this information to our office along with your current medical insurance information. Below are links to our patient registration and medical history forms.

    Patient Registration   Medical History      




Need Adobe Acrobat Reader?

If you do not have a copy of Acrobat Reader you can get one for free by clicking on the icon 'Get Acrobat® Reader'. This will take you to Adobe's website and enable you to download the Acrobat program to your computer.

 



 

David Grauer, DDS & Mark Kuchta, DDS: 101 S. Washington Ave | Suite 135 | Park Ridge, IL 60068 | Tel: 847-696-3240

Dentists Dr David Grauer, DDS and Dr Mark Kuchta, DDS offer: Teeth Whitening, Tooth Colored Fillings, Porcelain Veneers, Inlays & Onlays, Crowns, Bridges, Dental Implants, Dentures, Pit and Fissure Sealants, and TMJ Management

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