Patient Forms

Online Forms

These links will direct you to a secure server where you may complete your Health History form online.

Child Health History Form – Coming Soon
Adult Health History Form – Coming Soon

You may access the following policy to stay informed of your right to privacy. Please print the policy and keep it for your records.

Privacy Policy

Printable Patient Forms

If you prefer to download and print the forms, click on the following links to do so.

*These forms may require Adobe Acrobat Reader. Click the Adobe logo above to download.
We are committed to keeping your personal information secure. All of our online forms are submitted via a secure connection and are HIPAA compliant.

LOCATION

Weber Orthodontics
210 W Willow Ave
Wheaton, IL

Hours

Mon:11 am – 7 pm
Tues:8:30 am – 5 pm
Wed:9:00 am – 5 pm
Thurs:7:30 am – 4 pm
Fri: 9:00 am – 5 pm