New Patient Forms

We are happy to offer our patient forms online. Please feel free to print and fill them out at your convenience before your visit.

Health History

This form needs to be filled out before your first dental appointment.
Click here to download (62 KB)
 

Patient Liability Form

This form needs to be filled out before your first dental appointment.
Click here to download (370 KB)
 

Summary of Privacy Practices

This notice describes how health information about you may be used and disclosed and how you can get access to this information.
Click here to download (330 KB)
 

Appointment Protocol

Please read this document before your first dental appointment.
Click here to download (42 KB)
 

 
If you are unable to view the pdf files, please click on the icon below to download and install Adobe Reader:

Request Appointment

  • Monday
    Tuesday
    Wednesday
    Thursday
    Friday

  • Morning
    Afternoon
    Early Evening

Our Office

Po Dentistry

1661 Manheim Pike
Lancaster, PA 17601
Map & Directions
 
Phone: (717) 569-7319
Fax: (717) 569-2313
 

Office Hours*:
Monday11:00am-7:00pm
Tuesday 8:30am-5:00pm
Wednesday8:30am-5:00pm
Thursday8:30am-5:00pm
Friday 8:30am-12:30pm


*By Appointment Only