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Call: (717) 935-2295

Health Forms and Financials

If you are a new patient to our office, the attached files contain our three new patient  forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your dental needs more quickly than completing them on your arrival.  Thank you and please call our office if you have any questions at all.

Patient Medical History

Patient Registration

Financial Policy

Notice Of Privacy Practices 

HIPAA Acknowledgment 

We feel it is important to provide the highest quality dental care and to make this care affordable for you.  We encourage you to visit the website below to find out how easy it can be to afford good quality dental care. 

Care Credit - We are happy to announce we have partnered with Care Credit Financial!  This partnership will allow you to receive the dental care you need with a payment option that fits your budget.  You can even apply right online!

 Fair Health Consumer -  Think you're paying too much for dental care? Check out this great website for estimates and cost comparisons for our area. 

This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.


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