For Patients

Patient Forms

Dental and medical forms for your appointment.

Save time by completing the required dental and medical forms before your appointment!

New Patient Forms 

Print and complete each form. Bring with you to your first appointment OR fax completed forms to the office where the patient is seen.

If you see a dentist at the Broomall/Havertown office, forms may be emailed to:
We cannot accept emailed forms at any of our other offices.

Tip of the day

Calcium-fortified juices, milk and other dairy products, which are rich in calcium and vitamin D, help promote healthy teeth and bones, and reduce the risk for tooth loss.

Read more tips

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Visit our Adult Dentistry website to meet our dentists, view our services, and learn more about our patient information.

upper merion adult dentistry