Patient Forms - The Bartlett Dental Station

Before coming into our dental office, Dr. Prosniewski invites you to fill out our patient paperwork beforehand. You may download the forms by clicking on the links below, or use one of our online forms and submit them electronically to The Bartlett Dental Station. If you are not able to complete these forms prior to your first visit with our dentist in Bartlett, Illinois, please arrive 30 minutes before your scheduled appointment. Please feel free to contact our office today if you have any questions or if you need assistance. We are happy to help!

Download PDF
Patient Information
Privacy Acknowledgement
HIPPA Privacy Practices

Online Patient Form
Patient Information

Crowns A crown is the treatment of choice for a tooth that has been seriously compromised due to decay, fracture or over time when the tooth becomes weakened by a large filling or root canal. A crown will restore health and integrity to the tooth while providing natural looking beauty. Click here to learn more! Learn More>

Sleep Apnea Dentistry Sleep apnea is a potentially dangerous sleep disorder affecting the health of many people. Dr. Prosniewski is pleased to offer treatment for sleep apnea to protect our patients’ health and improve their overall well-being. Learn More>

Cosmetic Have you ever wished for a more beautiful smile? If so, we encourage you to contact us today at Bartlett Dental Station to learn more about our cosmetic services. Learn More>

Our focus is Restoring Confidence