We Welcome New Patients
We accept new patients of all ages. You will have the opportunity to meet with our team and get to know Drs. Teruyuki Hatakeyama, Ashlie Petrilli, and Thomas Hatakeyama. We are committed to educating you about your dental needs and will answer any questions you may have concerning your treatment.
Our goal is to provide you with the highest level of dental care available today. Thank you for your confidence in our dental office and we look forward to meeting you.
New Patient Forms
To provide you with the most efficient new patient experience, please download and complete the forms below and bring them to your first appointment. Our team will take comprehensive records and address any concerns or questions you may have. If you have any problems downloading the forms, please contact our office and we will gladly send them to you.
- Patient Information
- Dental History
- Health History
- Health History (Japanese)
- Cancellation Policy
Your First Visit
Your first visit with us may include:
- Comprehensive oral examination
- Full mouth digital x-rays
- Oral cancer screening
- Oral hygiene instruction
- Teeth cleaning
- One-on-one consultation with our dentist to discuss your needs, concerns, goals, and treatment options
During your visit, we will answer any and all questions about your oral health. We will provide a detailed financial consultation to ensure your treatments are timed effectively and affordably.
Insurance and Billing
We can help you maximize your benefits. We recommend that you contact our office prior to your appointment to provide us with insurance information for verification of benefits. We accept most major dental insurances and will file most claims for you as a courtesy. We will provide you with an explanation of your dental benefits and financial responsibilities up front, and work with you to ensure financing, if needed. We want as many people as possible to receive excellent dental care in Hoffman Estates, Illinois, and the surrounding areas. For this reason, we accept most insurance plans at Hoffman Estates Dental Professionals AMITA HEALTH/St. Alexius Medical Center, . Dr. Hatakeyama, Dr. Petrilli, and Dr. Hatakeyama, are all Delta Dental Premier providers. Dr. Ashlie Petrilli and Dr. Thomas Hatakeyama are PPO proivders for MetLife, CIGNA, Dental Network of America, Principal, Guardian, Humana, and Blue Cross/Blue Shield.
We provide multiple financing options to ensure you can receive the treatments you need with a plan you can afford. For your convenience, we accept payments made by cash, check, and credit card (Mastercard and Visa). We also have an in-office financing plan, and you can learn more about that by contacting our office. Please give us a call if you have any questions about our financial options. We are happy to assist you in any way we can.