For your convenience, we have provided our patient forms online. We invite you to fill them out before bringing your child to meet with Dr. Christa Spates, Dr. Komail Abbas or Dr. Sabeen Hafeez at Just Kidz Dentistry. This will streamline your appointment and give our dentists and team more time to focus on your child and their oral health needs. If you have any questions or would like to make an appointment at one of our dental offices in Peoria and Washington, Illinois, call us today.
New Patient Forms
Printable PDF
New Patient Health History
Financial Policy
Insurance Assignment of Benefits
Dental Insurance Information Form
HIPPA Policy