Patient Forms

We want to welcome you to the City Smiles family!

We are glad that you are interested in becoming a patient of Dr. William A. Simon’s Chicago, IL dental practice. New patients are always welcome here. Everyone at City Smiles is committed to making your visits pleasant and stress-free. You can count on our friendly, highly experienced staff to always provide the highest standard of dental care in a clean, state-of-the art environment. Your comfort is our top priority.

We look forward to seeing you soon!

Dr. William A. Simon and the City Smiles team

Click below to download New Patient Registration Materials