Monday: 8am-5pm
Tuesday: 8am-5pm
Wednesday: 8am-5pm
Thursday: 8am-4pm
Friday: Closed
Saturday: Closed
Sunday: Closed

Monday: 8am-5pm
Tuesday: 8am-5pm
Wednesday: 8am-5pm
Thursday: 8am-4pm
Friday: Closed
Saturday: Closed
Sunday: CloseD

717-945-7440

Healthy Smiles Dental at Woods Edge Plaza  |  144 S. Centerville Rd. at Columbia Ave., Lancaster, PA

Patient Forms

Healthy Smiles Dental invites patients to download and complete these patient forms prior to their visit

When you visit Healthy Smiles Dental, you will be asked to complete our patient forms. Please allow enough time to complete these before your appointment. As an added convenience, feel free download and complete these forms prior to your visit and bring them with you. Thank you for choosing Healthy Smiles Dental. We look forward to serving you!

You can fill out this form and email it, then sign it when you come to the office, or you can print it out, sign the filled-in form and bring it with you. (This packet also includes the Healthy Smiles Dental privacy notice and a form to request transfer of patient records to Healthy Smiles Dental)

Centerville     East Petersburg     Hempfield     Lancaster     Landisville     Manheim Township     Millersville     Mountville

Address: 144 S. Centerville Road, Lancaster PA 17603   |   Tel: 717.945.7440  Fax: 717-431-9731   |   e-mail: office@healthysmilesdentalpa.com

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