Buffalo Grove Patient Information
First and foremost, we'd like to welcome you to the Countryside Dental family! Our team can't wait to welcome you to our Buffalo Grove office.
For your convenience, our New Patient forms are available for download in PDF format. Simply print and complete your forms, and bring them with you to your first appointment.
New Patient Forms:
- Patient Information form
- Medical history form
- HIPAA Consent form
- Dental History form
- Appointment Cancellation Policy
- Financial Policy
First Dental Visit Preparation:
For your first visit to our office, please bring the following:
- Photo ID
- Your dental insurance card (if you will be using insurance)
- Your completed New Patient forms
First Appointment Expectations:
Your first visit to Countryside Dental will last for about one hour. During this time, we'll carefully assess your teeth and gums, take digital X-rays, and talk with you about your oral health history as well as any concerns you may have. A friendly member of our team will also give you a tour of our office, ensuring that you feel welcome and comfortable.
Following a thorough cleaning, Dr. Natalya will talk to you about the results of your exam and any recommendations regarding future treatment options. You'll have the opportunity to learn more about the cosmetic dentistry treatments we offer as well.
Your Child's First Dental Visit:
We happily welcome children to our Buffalo Grove dental office. Your son or daughter will receive a full exam, cleaning, fluoride treatment, and digital X-rays as needed. We will always spend extra time with our youngest patients, ensuring that they understand home hygiene and how diet affects oral health. We want your little one's smile to stay just as healthy as it is precious.
Our practice is in-network for nearly all major PPO plans, including:
- United Concordia
- Principal Financial Group
- Delta Dental
- BlueCross BlueShield
Convenient Patient Financing
If you don’t have dental insurance, or even if you do but find you still need help paying for out-of-pocket expenses at the dentist’s office, patient financing can provide help filling in the gaps. CareCredit is a great option for many patients. It works like a credit card you use solely for medical and dental expenses -- simply swipe the card and make payments at the predetermined rate that works best for you. Treatments costing $1,000 or more are eligible for payment plans across 24, 36, and 48 months. Those of $2,500 or more are eligible for a 60 month offer.
Get started with CareCredit now:
Register for CareCredit
For your convenience, we'll file your claims for you and do everything we can to maximize your available benefits.
We're always here to answer your questions, including everything from inquiries about insurance and services covered to helping you decide which treatment is best for you.