New Patient Registration Forms

We recognize that your time is valuable. We will make every attempt to see you at your scheduled appointment time. To save time, download our New Patient Registration Form. This may be easily completed using your keyboard and mouse. Print the completed form and fax it to us or bring it with you to your first appointment.

To print our New Patient Registration Form, please click on the link above. You will need Acrobat Reader, which is a free software program available by clicking the Get Adobe Reader button below.

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55 East Washington Street, Suite 2905, Chicago, Illinois 60602


Dr. Richard Johnson is a Chicago general and cosmetic dentist and is conveniently located on The Loop near Millennium Park, and welcomes new patients from the entire Chicagoland area, including downtown Chicago and suburbs. He provides dental services such as teeth whitening, porcelain veneers, porcelain crowns, dental implants, cosmetic tooth bonding, dental bridges, Invisalign clear braces, root canal therapy, digital x-rays, and general dental check-ups to promote dental health and help detect and prevent tooth pain, tooth decay, and gum disease, as well as oral cancer screenings.


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