New Patient Forms

To expedite your visit to our dental practice, we have provided the following patient forms. We invite you to print and complete these forms prior to your visit with our dentist in Chicago, Illinois. Please remember to bring the completed forms to your first appointment with Dr. Samia Rageb. 

If you need to reschedule your appointment, we ask that you give our dentist and team a call at least 24 hours prior to your appointment so we can better serve all of our patients. For more information on our cancellation policy, please feel free to contact our office.

Hours of Operation

Our Regular Schedule

Park View Smiles

Monday:

8:00 am-5:00 pm

Tuesday:

8:00 am-5:00 pm

Wednesday:

8:00 am-5:00 pm

Thursday:

8:00 am-5:00 pm

Friday:

Closed

Saturday:

By Appointment

Sunday:

Closed

Our Location

Find us on the map