Patient Information
New Patient Paperwork
Lincoln Park Center for Dental Anesthesia offers our patient form(s) online so they can be completed in the convenience of your own home or office.
- All forms are PDF files. You will need AdobeReader® to view them.
- If you do not already have AdobeReader® installed on your computer,
Click Here to download. - Download the necessary form(s), print them out and fill in the required information.
- Bring the necessary form(s) to your appointment.
Financial Policy
We firmly believe that financial considerations should not be an obstacle to obtaining the treatment you desire. We are sensitive to the fact that each patient has different needs and have several payment options available so that treatment is accessible to everyone. All financial discussions and arrangements are kept strictly confidential.
Payment Options
- Cash
- Check
- Visa
- MasterCard
- American Express
- Discover
- CareCredit®
Monthly Payment Plans
We also offer assisted financial plans through CareCredit®, an affordable option used by many of our patients to pay for their dental treatment. CareCredit® has 0% financing with monthly payment options available that can be used for co-payments, deductibles, treatment, and procedures not covered by insurance. Learn more at www.CareCredit.com.
Insurance Information
Dental insurance is diverse. Some policies cover only a small percentage of fees, while others cover 50 percent or greater. The more you or your employer pays for premiums, the better the coverage, in most cases. Dental insurance can be confusing, but we'll make it easy for you. Simply bring your card or claim into our office. We'll be happy to tell you what your insurance will cover and file your claim for you.
Lincoln Park Center for Dental Anesthesia
2551 N Clark St suite 502
Chicago IL 60614
(312) 596-2200
OFFICE HOURS
Office Hours are subject to change. Please call our office to confirm.
Monday
9:00am - 5:00pm
Tuesday
Closed
Wednesday
9:00am - 5:00pm
Thursday
Closed
Friday
9:00am - 5:00pm
Saturday & Sunday
Closed