Patient Forms | The Family Dentist

© 2019 by PC for The Family Dentist.                

Tel: 717-394-7218 | Em: mhkayepavilion@hotmail.com 1763 Columbia Avenue. Lancaster, PA 17603 

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Patient Forms

Get a head start on your appointment and fill out patient forms below! By giving Dr. K. Randy Martin  and Dr. Barton Kaufman your information beforehand, our dentists in Lancaster, Pennsylvania, can get you your care more quickly. If you would like to plan an appointment at The Family Dentist or have questions about completing your forms, call 717-394-7218.

Patient Medical History Form

This form is mandatory for new patients. To expedite your visit, print this form, fill it out and bring it with you for your first visit.

Privacy Notice

Please read over our Notice of Privacy Practices, acknowledging our privacy policy. The last page of our Privacy Practice Policy should be signed and be brought to your first appointment.

Extraction Care Sheet

Instructions for care after you have one or more teeth removed.  Please follow all instructions if you are having an problems please follow our emergency care information.

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