Patient Forms

Patient Forms for Your Southern York Dentist

Please download the forms below, fill them out, and bring them to your scheduled appointment with

  • Payment Options
  • Health History
  • Sedation Consent
  • Esthetic Evaluation
  • Privacy Statement

  • Please note:
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      Phone: 717-235-3871

      Address: Southern York Smile Care 4 S Main St Shrewsbury PA 17361