Forms & Finances

Online Forms. Flexible Financing.

Care Your Child Needs, When They Need It 

Milktooth has an ongoing dedication to delivering quality, convenient pediatric dental care for our local Chicago families. With parent-friendly online forms, adaptable financing options, and our affordable Milktooth Membership Plan, we’re here to bring you and your family the confidence and peace of mind to move forward.

Committed to Accessible Care

Accepted Insurances

To facilitate exceptional pediatric dental treatment for all children, we’re in-network with the following dental insurance providers:

  • Careington
  • Connection
  • Dental Network of America (Blue Cross Blue Shield)
  • Delta Premier
  • Humana
  • UnitedHealthcare
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Alternative Financing Options


At Milktooth Pediatric Dentistry, we’ll always go above and beyond to help your little one maintain a beautiful and healthy smile. That’s why we accept CareCredit. With CareCredit, you can seamlessly access top-notch dental care for your child - all without delaying appointments. Give our team a call today at (773) 904-0095, and we’ll be happy to verify your child’s treatment plan!

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Keeping Care Affordable

Milktooth Membership Plan

Dr. Amy Shah and the team are proud to offer comprehensive pediatric dental care with our annual $345 Milktooth Membership Plan! Our affordable plan features year-round treatments and services to provide your little one with stellar preventive care. Get in touch with us today to enroll and learn more!

*Cannot be combined with insurance. Payment due at time of service.

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Comprehensive Preventive Care

Routine preventive care treatments are essential to maintaining a healthy, happy grin. With our membership plan, your child will have access to 2 exams, 2 cleanings, 2 fluoride treatments, and all necessary x-rays to keep their smile dazzling all year long.

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Whether your little one is experiencing a toothache or discomfort, our plan covers a comprehensive emergency exam. During this exam, Dr. Amy will gently assess your child’s oral health, provide an accurate, acute diagnosis, and recommend the best plan of action to get them out of pain and smiling again.

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Outstanding Savings on All Services

From frenectomies to dental fillings, our membership plan includes a 20% discount on all services, and a 10% discount on our annual membership fee when you sign up with 2 or more kids!

It’s Easy to Get Started

Online New Patient Forms

Our practice values bringing simplicity and delight into every aspect of our care. That includes streamlining patient forms, so we can help you create an effortless first visit. With our online new patient forms, you can fill out your child’s information at your convenience, making room to relax and be present with your little one on the day of their appointment.

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Preparing for Success

School Form Available

At Milktooth, we’ll do everything we can to make taking care of your child’s smile a breeze. If your little one is headed back to school and needs proof of a dental exam with us, we’re more than happy to help you fill out the State of Illinois Proof of Dental Examination form.

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get in touch

refer a patient

We believe that every child deserves personalized and engaging care. That's why we'd be thrilled to work with you in providing the best care possible for your referred patients. Our team of experts offer comprehensive, age-appropriate treatments tailored to each child's unique needs. If you're ready to refer a patient, fill out the fand submit it to our front office team at We look forward to connecting with you soon!

download referral form
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New to Milktooth Pediatric Dentistry?

First Visit is Free for Tiny Brushers Under 2!