{"id":1825,"date":"2023-08-16T13:43:05","date_gmt":"2023-08-16T13:43:05","guid":{"rendered":"http:\/\/mydentalart.websitemockup4u.com\/?page_id=1825"},"modified":"2026-09-18T21:00:04","modified_gmt":"2026-09-18T21:00:04","slug":"dental-art-clinic-forms","status":"publish","type":"page","link":"https:\/\/mydentalart.com\/pl\/dental-art-clinic-forms\/","title":{"rendered":"FORMY"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1825\" class=\"elementor elementor-1825\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e3609dc elementor-section-stretched elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"e3609dc\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;background_background&quot;:&quot;classic&quot;,&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b8ce9be\" data-id=\"b8ce9be\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c3e64d3 elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"c3e64d3\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;slideInDown&quot;,&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">DENTAL ART CLINIC FORMS<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5ebb0a4 elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"5ebb0a4\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;slideInDown&quot;,&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"line\"><p>To make your visit to <a href=\"https:\/\/mydentalart.com\/\"><span style=\"color: #d9cdc0;\">Dental Art Clinic<\/span><\/a> as convenient as possible, we provide new patient registration forms in PDF format.<\/p><p>Download, print a pdf form at home, fill in the information and bring the completed forms with you for your <a href=\"https:\/\/mydentalart.com\/request-an-appointment\/\"><span style=\"color: #d9cdc0;\">scheduled appointment.<\/span><\/a><\/p><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-db51aba elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"db51aba\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;slideInDown&quot;,&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"line\"><p>At <strong data-start=\"3\" data-end=\"44\"><span class=\"hover:entity-accent entity-underline inline cursor-pointer align-baseline\"><span class=\"whitespace-normal\">Dental Art Clinic<\/span><\/span><\/strong>, we understand that your time matters. That\u2019s why our downloadable new patient forms are designed to streamline your first visit and minimize waiting time at our office. By completing your paperwork in advance, our team can review your medical and dental history ahead of your appointment, ensuring a smoother check-in experience for families and individuals visiting us from <strong data-start=\"421\" data-end=\"462\"><span class=\"hover:entity-accent entity-underline inline cursor-pointer align-baseline\"><span class=\"whitespace-normal\">Mount Prospect<\/span><\/span><\/strong>, <strong data-start=\"464\" data-end=\"505\"><span class=\"hover:entity-accent entity-underline inline cursor-pointer align-baseline\"><span class=\"whitespace-normal\">Wheeling<\/span><\/span><\/strong>, and <strong data-start=\"511\" data-end=\"552\"><span class=\"hover:entity-accent entity-underline inline cursor-pointer align-baseline\"><span class=\"whitespace-normal\">Arlington Heights<\/span><\/span><\/strong>.<a href=\"https:\/\/mydentalart.com\/request-an-appointment\/\"><span style=\"color: #d9cdc0;\">.<\/span><\/a><\/p><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7a37527 elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"7a37527\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;slideInDown&quot;,&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"line\"><p>Filling out your registration forms beforehand also allows us to better personalize your care. Whether you\u2019re scheduling a routine dental cleaning, a cosmetic consultation, or specialized treatment, having accurate information helps our dentists prepare for your needs in advance. If you have any questions while completing the forms, our friendly front desk team is always available to assist you before your visit.<\/p><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-0c6d9d5 elementor-section-stretched elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"0c6d9d5\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;background_background&quot;:&quot;classic&quot;,&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3b81088\" data-id=\"3b81088\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1964cd4 elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"1964cd4\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;slideInDown&quot;,&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Book Now!<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ab58ec8 elementor-button-align-center elementor-widget elementor-widget-form\" data-id=\"ab58ec8\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;,&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"New Form\" aria-label=\"New Form\" novalidate=\"\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"1825\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"ab58ec8\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Dental Art Clinic Forms | Dental Art Clinic Mount Prospect IL\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"1825\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"First Name\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_95f2a87 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_95f2a87]\" id=\"form-field-field_95f2a87\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Last Name\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-field_ffb51e2 elementor-col-50\">\n\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[field_ffb51e2]\" id=\"form-field-field_ffb51e2\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Phone\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Akceptowane s\u0105 jedynie cyfry i znaki telefoniczne (#,-,*).\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Email\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_fb82076 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_fb82076\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDo you have Insurance?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_fb82076-0\" name=\"form_fields[field_fb82076]\"> <label for=\"form-field-field_fb82076-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-field_fb82076-1\" name=\"form_fields[field_fb82076]\"> <label for=\"form-field-field_fb82076-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_fb151eb elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_fb151eb\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNew Patient or Existing\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"New\" id=\"form-field-field_fb151eb-0\" name=\"form_fields[field_fb151eb]\"> <label for=\"form-field-field_fb151eb-0\">New<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Existing\" id=\"form-field-field_fb151eb-1\" name=\"form_fields[field_fb151eb]\"> <label for=\"form-field-field_fb151eb-1\">Existing<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-field_1a9be80 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_1a9be80\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPreferred Day and Time for an Appointment\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_1a9be80]\" id=\"form-field-field_1a9be80\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field elementor-use-native\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-message elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-message\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWhere did you hear about us?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[message]\" id=\"form-field-message\" rows=\"2\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_b20b8a3 elementor-col-100\">\n\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_b20b8a3]\" id=\"form-field-field_b20b8a3\" rows=\"4\" placeholder=\"Reason for Appointment\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-recaptcha elementor-field-group elementor-column elementor-field-group-field_063f3d9 elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-field\" id=\"form-field-field_063f3d9\"><div class=\"elementor-g-recaptcha\" data-sitekey=\"6Lft0sUtAAAAAB_AmxvV-wSq6DuWsAbzJk_zNwMw\" data-type=\"v2_checkbox\" data-theme=\"light\" data-size=\"normal\"><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Send<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>DENTAL ART CLINIC FORMS To make your visit to Dental Art Clinic as convenient as possible, we provide new patient registration forms in PDF format. Download, print a pdf form at home, fill in the information and bring the completed forms with you for your scheduled appointment. At Dental Art Clinic, we understand that your&hellip; <a class=\"more-link\" href=\"https:\/\/mydentalart.com\/pl\/dental-art-clinic-forms\/\">Czytaj dalej <span class=\"screen-reader-text\">FORMY<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_templately_pack_id":"","_templately_imported_at":"","_templately_source":"","_templately_import_session_id":"","footnotes":""},"class_list":["post-1825","page","type-page","status-publish","hentry","entry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Dental Art Clinic Forms | Dental Art Clinic Mount Prospect IL<\/title>\n<meta name=\"description\" content=\"Download patient forms for Dental Art Clinic in Mount Prospect, IL, including new 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