Poplar Crossing Dental
Patients Call:
847-884-8484
  • Home
  • About Us
    • Meet Dr. William Becker
    • Meet Our Staff
    • What to Expect Your First Visit
    • Request an Appointment
    • Map to Our Office
    • Patient Forms
    • Financial Policies
  • Smile Gallery
  • Cosmetic Dentistry
    • Cosmetic Dentistry
    • Dental Crowns
      • Porcelain Crowns
      • Zirconia Crowns
      • e.max Crowns
    • Teeth Whitening
    • Zoom Whitening
    • Dental Bonding
    • Porcelain Veneers
    • Invisalign
  • Tooth Replacement
    • Dental Implants
    • Implant vs Bridge
  • Other Services
    • Emergency Dentistry
    • Family Dentistry
      • Pediatric Dentistry
      • Dental Tips for Parents
      • Family Dentistry
    • Toothaches
      • Toothaches
      • Root Canal Treatment
    • Preventive Dentistry
    • Sedation Dentistry
    • TMJ Treatment
    • Mercury-Free Dentistry
the house of sophisticated
dentistry

Patient Forms

Please click on the links below to download the forms. Please complete the registration and history forms in advance of your dental appointment and bring them with you to the appointment.

  • Adult Registration
  • Smile Evaluation
  • Adult Medical/Dental History
  • Child Dental History and Habits
  • Helpful Dental Hints for Children
"Fellowship in the Academy of Dentistry International is bestowed on dentists whose professional, civic, and related accomplishments are truly outstanding."
– Academy of Dentistry International website
Woman with a smile makeover

Smile Gallery

Bringing out smiles on people’s faces is one of the most enjoyable things we do.

Make the first step towards a beautiful smile
Contact Us
Conveniently located just off Route 59 (Sutton Rd) and use the North exit off I-90. Please contact us to schedule an examination.

Address
2630 N Sutton Rd
Hoffman Estates, IL 60192
847-884-8484
Reviews
Office hours
Monday: 8:00am – 6:00pm
Tuesday: 8:00am - 5:00pm
Thursday: 8:00am – 6:00pm
Friday: 8:00am – 3:00pm
Wednesday, Saturday: By appointment
Sunday: Closed
location map of Poplar Crossing Dental office

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Menu
Phones
  • Home
  • About Us
    • Meet Dr. William Becker
    • Meet Our Staff
    • What to Expect Your First Visit
    • Request an Appointment
    • Map to Our Office
    • Patient Forms
    • Financial Policies
  • Smile Gallery
  • Cosmetic Dentistry
    • Cosmetic Dentistry
    • Dental Crowns
      • Porcelain Crowns
      • Zirconia Crowns
      • e.max Crowns
    • Teeth Whitening
    • Zoom Whitening
    • Dental Bonding
    • Porcelain Veneers
    • Invisalign
  • Tooth Replacement
    • Dental Implants
    • Implant vs Bridge
  • Other Services
    • Emergency Dentistry
    • Family Dentistry
      • Pediatric Dentistry
      • Dental Tips for Parents
      • Family Dentistry
    • Toothaches
      • Toothaches
      • Root Canal Treatment
    • Preventive Dentistry
    • Sedation Dentistry
    • TMJ Treatment
    • Mercury-Free Dentistry