Patient Forms

We invite you to visit Institute of Dental Implants and Periodontics to improve your gum health and strengthen your smile. New patients are encouraged to complete our patient forms in advance so that we can receive your medical information before your visit. If you have any questions, please call Drs. Domagala and Shango, our periodontists in Gurnee, Illinois. Our team is happy to assist you.

Child Registration
Adult Registration