Patient Registration

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Patient Registration

For more information, or to schedule a consultation with Bi-State Oral and Facial Surgery, please call our office in Alton, IL at Alton Office Phone Number 618-462-1646 or our office in Edwardsville, IL at Edwardsville Office Phone Number 618-692-1435, or Request an Appointment Online.