For your convenience, register with our office by selecting the Registration Forms button below, and filling out our secure forms.

• After you have completed the form, make sure to press the Complete and Send button at the bottom.

• On your first visit to our office, we will have your completed form available for your signature. 

If you prefer to download and fill out forms at home, click the button below.

Please bring the following to your appointment:

  • Driver’s License
  • Insurance Cards
  • Surgical Referral Slip
  • Any necessary applicable x-rays
Crystal Lake Oral & Maxillofacial Surgery Logo
  Treating our patients as we would our own families.

Crystal Lake Oral & Maxillofacial Surgery
Doctors Conlon, Bruksch, Ozment, Richard, Fay and Schmidt

690 N. Route 31
Crystal Lake, IL 60012
Phone: 815-459-5600
FAX: 815-459-5601

Office Hours
Monday – Friday 8:00 am – 5:00 pm
Saturday 8:00 am – noon
Hours may vary occasionally due to hospital surgery and emergencies.

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