Patient Forms - Highland Park Deerfield IL | Eisen Orthodontics
patient forms

Creating confident smiles
through advanced
orthodontic care

Patient Forms

Please help us be prepared for your first appointment by completing an online patient health history form.

Adult Health History Form Child Health History Form Privacy Policy

Visiting Our Office

During your first visit to our office, Dr. Eisen will conduct a preliminary, complimentary examination to determine your treatment needs and goals. If orthodontic treatment is indicated, we will schedule a further appointment to take complete diagnostic records, including digital X-rays, photographs and impressions.

  • X-rays are taken to look at the root structure of the teeth and to see how the jawbones and teeth relate to each other. Eisen Orthodontics uses digital radiography, which protects our patients from unnecessary radiation. It is also a more environmentally friendly technology, as it avoids the use of harsh chemicals associated with traditional X-ray processing.
  • Photographs are taken to evaluate facial proportions, facial aesthetics, and the overall health of the teeth and gums.
  • Impressions, or molds, are used to develop models for closer examination of the teeth as well as to depict how the upper and lower teeth relate to each other.

Collectively, these records enable Dr. Eisen to develop an individualized treatment plan that optimizes each patient's smile. These records are also helpful in tracking the progress of treatment as the teeth move under orthodontic care.


After Dr. Eisen has evaluated your records, he will discuss his recommended treatment plan with you in detail, including the estimated cost and treatment time for your particular case.

Regular Appointments

Ready to get started? The appointment when you get your appliances (braces, expanders, etc.) typically takes from 60-90 minutes. You'll then see us at regular intervals between 4 to 8 weeks apart for an adjustment, which takes 20 to 40 minutes.

To ensure we dedicate appropriate time to all of our valued patients, our office operates by appointment only. We make every effort to be on time for our patients, and our schedule is carefully set with this objective in mind. For example, we typically schedule longer appointments during the day and shorter appointments — which comprise the majority of your office visits — before or after school hours. This allows us to accommodate the maximum number of patients during after-school hours, helping to minimize school absences.

If you find that you cannot keep an appointment, please notify us immediately, and cancel only if it is an emergency. Missing appointments can delay treatment progress.

Payment & Office Policies


The cost of orthodontic treatment depends on many factors, including the severity of the problem, its complexity, and the length of treatment. At Eisen Orthodontics, we offer a variety of convenient payment plans and accept all qualified forms of insurance. We are committed to working with our patients to identify the financing options that will work best for their individual budgets. We believe that — dollar for dollar — the lifetime benefits of orthodontics translate to a great value.


If you have insurance, we will help you determine available coverage. Please provide us with insurance information when scheduling your first appointment so we may provide you with an estimate of insurance benefits at your preliminary examination. Typically, we ask that you assign your insurance benefit to us, and the balance will be arranged for you to pay. We will help in every way we can in filing your claim and handling insurance questions from our office on your behalf.