New Patient Forms
Our doctors understand you have a choice when choosing your dentist and they thank you for entrusting your care to our office
What to Bring: Forms, Medications List, X-Rays
Prior to your first visit, we ask you to complete the documents below and bring them with you to your first appointment
Please bring a list of medications, both prescription and over-the-counter, with the phone number of your current medical doctor, homeopath, chiropractor, herbalist or any of the other therapists you work with.
If you have any X-rays from your previous dentist that are less than one year old and are of good (readable) quality, please have those X-rays with you or please email them to: firstname.lastname@example.org
New Patient Forms
Please complete all the forms below and bring them with you on your first visit
HIPAA Privacy Act (for your reference)
When you first meet with our doctors, you learn very quickly that their interests in our patients go beyond simply “fixing a broken tooth.” Dr. Aver and Dr. Ganzman will take the time to get to know you and the state of your overall health. They will go over your medical history and address any and all specific questions you have and/or provide consultation related to a certain issue you may be experiencing.
Whether you realize it or not, an examination from our doctors is most likely very different from what you have experienced from traditional dentists in the past. As part of the examination, several screenings and evaluations will be performed. This involves examining your head and neck for possible abnormalities and cancer by touching your neck muscle, salivary glands and lymph nodes. Our doctors also perform a craniosacral evaluation, which is done to release any tension in the jaw, bones and teeth, restoring a natural balance to the patient’s mouth, hard palate, and temporomandibular joints through gentle touches and very light pressure.
A noninvasive Temporomandibular Disorder (TMD) exam will also be done. Our doctors will analyze your left and right Temporomandibular Joints (Jaw Joints), since according to the teachings of the Oriental medicine they are considered to be one of the major energy points of the body.
Your oral exam will include oral cancer screen , tongue screening , and microscopic bacterial evaluation.
A traditional exam of the teeth is done; noting missing teeth and existing restorations. Then a comprehensive gum exam and evaluation is performed; measure the periodontal pockets (gum pocket) around your teeth to diagnose and detect possible gum disease. Finally, using an intraoral camera we will analyze your teeth using magnification and will take any necessary digital x-rays.
Dr. Aver and Dr. Ganzman take the time to discuss in detail wellness and treatment options with our patients. They always works with you to develop the most appropriate treatment plan that is inline with your health philosophy and needs.
If you have any questions, please contact our office at 847-998-5100.
We look forward to meeting you soon!
At the Center for Dental Healing we specialize in patients with sensitive health issues such as fragrance allergies. Due to this, if at all possible, we respectfully request that our patients avoid strong perfumes or other fragrances when visiting the office. Thank you.