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

Teens should wait to use tooth-whitening products until at least age 14, at which time the tooth’s pulp (nerve) is fully formed and the teen will experience less sensitivity. Teens should always consult their dentist before using an over-the-counter teeth-whitening product.

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