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Mon–Thu 8:00 AM – 5:00 PMFri–Sun Closed

(309) 243-8455
Martin Ruelas, DMD Family Dentistry · Peoria & Dunlap

Patient Forms

New patient forms to print and complete before your first appointment at the practice.

Completing your paperwork before you arrive saves time in the waiting room and means your first appointment starts on time.

These forms are printed and filled in by hand, then brought with you. There is no online form here, and that is deliberate — your medical history is not something this website collects, stores or transmits.

Martin Ruelas, DMD, PC

Dare to have the smile you've always wanted.

10330 North Juliet Court
Suite 1
Peoria, IL 61615

(309) 243-8455 Fax (309) 243-8466

Office hours

  • Mon–Thu 8:00 AM – 5:00 PM
  • Fri–Sun Closed

Closed Friday through Sunday. Requests sent over the weekend are answered on Monday.

© 2026 Martin Ruelas, DMD, PC. All rights reserved.

Serving Peoria and Dunlap, Illinois.