Notice of Non-Discrimination

Oak Park Dental Studio complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Oak Park Dental Studio does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Oak Park Dental Studio:

  • Provides free aids and services to people with disabilities to communicate effectively with us, such as:
    • Qualified sign language interpreters
    • Written information in other formats (large print, audio, accessible electronic formats, other formats)
  • Provides free language services to people whose primary language is not English, such as:
    • Qualified interpreters
    • Information written in other languages

If you need these services, contact Oak Park Dental Studio.

If you believe that Oak Park Dental Studio has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Oak Park Dental Studio, 1234 N Berendo Street, , Los Angeles, California 90029, Phone: 123312312, (TTY 123312312), Fax: 123123123, Email: . You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Oak Park Dental Studio is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019 ,800-537-7697 (TDD)

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.


ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 123312312 (TTY: 123312312).

UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 123312312 (TTY: 123312312).

注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 123312312 (TTY:123312312)。

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 123312312 (TTY: 123312312)번으로 전화해 주십시오

PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 123312312 (TTY: 123312312).

ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم 123312312 (رقم هاتف الصم والبكم: 123312312).

ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 123312312 (телетайп: 123312312).

સુચના: જો તમે ગુજરાતી બોલતા હો, તો નિ:શુલ્ક ભાષા સહાય સેવાઓ તમારા માટે ઉપલબ્ધ છે. ફોન કરો 123312312 (TTY: 123312312).

ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم -xxxx-xxx-xxx) رقم .(xxx-xxx-xxxx-1 :والبكم الصم ھ

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 123312312 (TTY: 123312312).

ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 123312312 (TTY: 123312312).

ध्यान द: यद आप हदी बोलते ह तो आपके िलए मुफ्त म भाषा सहायता सेवाएं उपलब्ध ह। 123312312 (TTY: 123312312) पर कॉल कर ।

ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 123312312 (ATS : 123312312).

ΠΡΟΣΟΧΗ: Αν μιλάτε ελληνικά, στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης, οι οποίες παρέχονται δωρεάν. Καλέστε 123312312 (TTY: 123312312).

ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 123312312 (TTY: 123312312).

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Oak Park Dental Studio
Joseph Lepkowski, DDS

6630 W. Roosevelt Road
Oak Park, IL 60304

(708) 386-2233
Fax (866) 216-6177

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We would like to welcome all of our New Patients!

Please take a moment to print out and complete the New Patient Forms below and bring them to your first appointment.

 

Medical History Form

Practice Guidelines

Credit Card Authorization Form

Medical History Form Spanish

Practice Guidelines Spanish

Credit Card Authorization Form Spanish

COVID-19 Patient Disclosures [English] [Español]

COVID-19 Pandemic Dental Treatment Notice and Acknowledgement of Risk [English] [Español]


Referral Instructions

Pre Treatement Instruction for Oral Surgery

Oral Care After Surgery

Our Location

Find us on the map

Hours of Operation

Our Regular Schedule

Primary Location

Monday:

9:00 am-4:00 pm

Tuesday:

1:00 am-7:00 pm

Wednesday:

We stop to smell the roses

Thursday:

1:00 am-7:00 pm

Friday:

8:00 am-2:00 pm

Saturday:

8:00am - Noon (1 Sat / mth)

Sunday:

Closed