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Dr. Rita Tempel
Gettysburg Smiles
Beautiful and Comfortable Dentistry
Call: (717) 339-0033

Patient Forms

 Dentist Dr. Rita Tempel Offers Patient Forms To Fill Out Online

 

If you are a new patient to our office, the attached files contain our new patient bundle with 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 medical needs more quickly than completing them on your arrival.  Thank you and please call our office if you have any questions at all.

Patient Information

Medical History

Dental History

Financial Policy

HIPAA Consent Form

 

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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Dr. Rita Tempel
2018 York Road Gettysburg, PA 17325
Phone: (717) 339-0033 URL of Map