New Patient Form

Fill Out Important New Patient Forms

Save Time During Your First Visit to Our Clinic

When you schedule an appointment at Gaitros Dental, filling out our new patient forms prior to the visit ensures that your visit is easier and convenient. We'll have all your required information in the form so that makes our job easier as well!

If you need any help while filling out the forms, feel free to call us at 217-875-5020.

Download and Fill Out the Following Forms

$25
New Patient Exam
and X-Rays

Call 217-875-5020 for an appointment.

Why Choose Gaitros Dental?

  • Full-service dental center
  • Most insurance accepted
  • Accepting new patients
  • Payment plans available
  • Walk-ins welcome
  • Emergency care available
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