Patient Forms

You may preregister with our office by printing and filling out our online New Patient Forms. After you have completed the forms, please be sure to bring them with you at the time of your appointment or you may email them to us at [email protected] or fax them to us at 717-249-0951.
 
You may also use our Records Transfer Request form below to have your records transferred from your previous dentist.
A PARENT OR LEGAL GUARDIAN MUST BE PRESENT WITH ANY CHILD UNDER THE AGE OF 18!
ALL PAPERWORK MUST BE SUBMITTED TO US PRIOR TO YOUR APPOINTMENT!
PLEASE NOTIFY US OF ANY CURRENT X-RAYS PRIOR TO ANY APPOINTMENT SO WE CAN BE SURE TO HAVE THEM BEFORE YOUR ARRIVAL!
NEW PATIENTS CLICK ON THE LINK BELOW TO REGISTER
PLEASE CLICK ON THE LINK BELOW TO UPDATE YOUR MEDICAL HISTORY!