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Champaign & Mahomet, IL's Favorite Orthodontist
217.356.9595

New Patient Form

You may access the following patient form to assist us with your orthodontic care. Please print and fill out the below form. You can either email it to us at info@shafersmiles.com or bring the form with you for your appointment. You will need Adobe Reader to electronically fill out the form and submit by email to our Homewood, IL orthodontics office. Download Adobe Reader here



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Read What Our Patients Are Saying…

Great waiting area for parents!

- Vicki C.


best orthodontist champaign il
I just started with Dr. Shafer, but when I walked into the office there was a whiteboard that said, " Welcome to our office Julia!" I was SO nervous, and seeing that sign made me feel better. They're so nice that it makes me want to get braces!

- Julia R.


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*The reviews listed are from actual patients of Dr. Robert Shafer. Individual results may vary. Reviews are not claimed to represent results for everyone.
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