Dentist Sandwich Patient Forms

From the first day you join our office, we will cater to your dental needs. As part of your first visit with us, you will fill out a comprehensive medical and dental history. These forms are important because they help us to determine the course of your treatment. We have to know about allergies, sensitivity to anesthetics, long-term medications, etc.

For your convenience we've included these forms below. Click on the links to download and print out these forms at home, where you can fill them out at your leisure and bring them with you to your first visit.


In addition to the New Patient Forms, we have our instructions for post-operative care for many procedures as well.  Please feel free to download and print these instructions, or just open the link and review them at your convenience.  The forms can be helpful with questions that you may have concerning treatment that was just completed and for healing after dental surgery.  If you have other questions or concerns that are not addressed on the post-operative forms, please contact our office at 1-815-786-9811 and we will be glad to help you.


Thank you for choosing First Impressions by Lerohl & Landers for your dental health care!


If you are at home, click the link below:


At Home New Patient Form <<<< Click Here



If you are in our office, click this link:


In Office New Patient Form <<<< Click Here




Click below to read or print any post treatment instructions.


Post-Op Instructions:  Scaling&Root Planing

Post-Op Instructions:  Crown or Bridge

Post-Op Instructions:  Denture

Post-Op Instruction:  Root Canal

Post-Op Instruction:  Tooth Extraction

Post-Op Instruction:  Fillings


Bleaching Instructions


Implant Consent Form