Patient Forms
Online Patient Forms
The below patient forms can be completed online before your visit to Reflection Dental. Click the links below to get started!
Patient Intake Form
Click here to access our patient intake form to complete ahead of time.
Patient Intake Form (Spanish)
Click here to access our patient intake form to complete ahead of time.
Printable Patient Forms
If you do not complete the online forms above, the below patient forms can be printed and completed before your visit to Reflection Dental. Please bring the completed forms with you during your appointment.
Patient Intake Form
Click here to access our patient intake form to download, print, or complete ahead of time.
Patient Intake Form (Spanish)
Click here to access our patient intake form to download, print, or complete ahead of time.
Dentist Near You
Address:
346 E North Ave
Lombard, IL 60148
Hours
Monday: 10:00 AM - 6:00 PM
Tuesday: 11:00 AM - 7:00 PM
Wednesday: By Appointment
Thursday: 11:00 AM - 7:00 PM
Friday: 10:00 AM - 2:00 PM
Saturday: Closed
Sunday: Closed
Excellence in Dental Care for the Entire Family
Contact Us Today for an Appointment
Don’t wait, schedule your appointment with our friendly dental team today and keep your smile healthy and bright.