Patient Forms

Please feel free to fill out and submit these forms to us online as they really do help us take better care of our patients. It also provides Dr. Michael Danner and his team to get to know more about you! You may print them off and bring them to your first visit with our dentist at Danner Family Dentistry. It is our pleasure to treat you with the highest quality care and dentistry in Pekin, Illinois. We welcome you to call our team if you have any questions about our forms.

Downloadable Forms

Health History
HIPAA
Insurance Checklist
MEDICAL Payment
Patient Dental History
Personal Info
Patient Registration