Cosmetic Dentistry

New Patient Forms

For your convenience, all our new patient forms are available to you as Adobe Acrobat files. We recommend printing and completing these forms at home and bringing them with you to your first appointment.

If you have any problems getting these files to print, please call our office at 312.565.0014 and we will be happy to send or fax them to you. Please bring your completed forms with you for your first appointment.

New Patient Registration Forms Medical History Form Dental History Form

Financial Policy Forms

Direction Info

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312.565.0014 - Chicago

155 North Michigan Avenue, Suite 323
(Downtown) Chicago, Illinois 60601
(312) 565-0014

Over the years, Dr. Usheroff has established a reputation as a talented, gentle Chicago cosmetic dentist. He treats all of his smile makeover Chicago patients with the utmost attentiveness and dedication, an approach that helps him consistently deliver remarkable aesthetic results. Dr. Usheroff has extensive experience performing a variety of sophisticated procedures, including laser gum recontouring and teeth whitening in Chicago. In addition, he is renowned as one of the foremost Downtown Chicago veneers and crowns experts.

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