Please ensure Javascript is enabled for purposes of website accessibilityOrthodontic Patient Forms | Homer Glen Braces | Booth Orthodontics
  • 12635 W. 143rd St., Homer Glen, IL 60491
  • 708-301-0005
  • 708-301-0005
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Patient Forms

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Save time at your first appointment and download, print and complete the following forms and bring them with you to your first appointment.

  • Health History Form
  • Responsible Party Info
  • Insurance Info
  • Privacy Notice
  • Receipt of Privacy Notice
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We're always here for you. Contact us with any questions, comments or to schedule an appointment.

HOURS
M: 11:00 AM - 7:00 PM
T: 11:00 AM - 5:00 PM
W: 9:00 AM - 5:00 PM
Thurs: 11:00 AM - 5:00 PM

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12635 W. 143rd St.
Homer Glen, IL 60491

M: 11:00 AM - 7:00 PM
T: 11:00 AM - 5:00 PM
W: 9:00 AM - 5:00 PM
Thurs: 11:00 AM - 5:00 PM

  • Free Consult
  • New Patients
    • New Patients
    • Patient Forms
    • Your First Visit
    • Insurance & Finances
    • Free Consult
    • Virtual Consult
  • About Us
    • About Us
    • Why Choose Us
    • Meet the Doctors
    • Meet the Team
    • Reviews & Testimonials
    • Smile for a Lifetime
    • Homer Glen Office
    • Our Blog
  • Our Treatments
    • Our Treatments
    • Metal Braces
    • Clear Braces
    • Invisalign
    • Ortho for All Ages
    • Early Treatment
    • Technology
    • Ortho Instruction & Care
    • Caring for Braces
    • Caring for Invisalign
    • Retainer Options
    • Retainer Insurance
  • Contact Us
    • Contact Us
    • Free Consult
    • Doctors: Refer a Patient
    • Dentists: CBCT Imaging Referral
    • Patient: Refer a Friend
    • Patient Login
    • Virtual Consultation
    • Review Us
  • About Us
    • Why Choose Us
    • Meet the Doctors
    • Meet the Team
    • Smile for a Lifetime
    • Tour Our Office
    • Our Blog
  • Our Work
    • Reviews & Testimonials
  • Treatments
    • Metal Braces
    • Clear Braces
    • Invisalign
    • Orthodontics for All Ages
    • Ortho Instruction & Care
      • Caring for Braces
      • Caring for Invisalign
      • Retainer Options
      • Retainer Insurance
  • New Patients
    • Patient Forms
    • Your First Visit
    • Insurance & Finances
  • Contact Us
    • Doctors: Refer a Patient
    • Dentists: CBCT Imaging Referral
    • Refer a Friend
    • Virtual Consultation
    • Review Us
Book a Free Consult

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Our Location

12635 W. 143rd St.
Homer Glen, IL 60491

Call Us
(708) 301-0005