Brookfield Smiles Inc.

8908 Ogden Avenue
Brookfield, Illinois 60513
(708) 498-4698

New Patient Information

Patient Forms

Below are the Medical History and Privacy Policy forms you'll need to complete on your first visit. You can expedite matters by filling them out and submitting them online or downloading these forms, completing them at home and handing them to our staff when you arrive for your initial visit to our office.

Patient Registration Forms

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.


Welcome to our office! We appreciate the confidence and trust that you have placed in us and look forward to meeting you personally and professionally. Your first visit to our office establishes a vital foundation for our relationship with you. We will take the time to get to know you (and you, us) during the first visit; we make sure to obtain important background information and give you time to get to know your doctor. We will perform a comprehensive dental evaluation and gather information to make a customized plan for you. To understand what to expect from your first visit to our practice, please read through this page. You’ll find all the practical information you need, such as practice hours, patient forms and more.

Our Mission

Our philosophy of care governs everything we do for you. It consists of the following key elements:

  • We are truly caring about our patients and want you to feel very comfortable with our entire staff
  • We recognize that each patient is an individual and our goal is to help you retain your teeth in comfort, function and esthetics for a lifetime.
  • We strive to be thorough in everything we do, taking the time to be the best we can be.
  • We are esthetics oriented, helping you look your best, while maintaining optimum comfort, function and health.
  • Patient Login

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    Patient Login