Patient Resources

(Click on a Clipboard Link Below for the Forms You Need)

For your convenience, we have grouped together the most commonly used forms and resources, below.  Simply select the type(s) of forms to complete by clicking on the applicable clipboard icon.  If you need assistance reading or understanding the forms, please contact our Premier Dental of Gettysburg office at 717-338-9905.

New Patient Intake Forms

NEW PATIENT FORMS

If you are a new patient who has not yet been seen at our office, please click on the “New Patient” clipboard link and complete/submit the patient information forms.  The forms will open in a new tab and be submitted securely to our office.  Thank you.

HIPAA FORMS

We maintain a HIPAA (Health Insurance Portability and Accountability Act) compliant privacy policy.  Please click on the “HIPAA Notice of Privacy Practices” Clipboard to view, download and print our Privacy Policy.  The forms will open in a new tab and be submitted securely to our office.  Thank you.

INSURANCE FORMS

To file your payment information or an insurance claim, please click on the “Financial and Insurance Info” Clipboard to learn about payment options and to enjoy discounted billing by joining the PDC Dental Membership Club.  Thank you.

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CONTACT INFORMATION:

Address:
1275 Biglerville Road
Gettysburg, PA 17325
Phone: 717-338-9905
Fax: 717-338-9906
Email: Office@PDGettysburg.com

DENTAL CLINIC HOURS:

Monday: 7:30am-5:00pm
Tuesday: 7:30am-5:00pm
Wednesday: 7:30am-5:00pm
Thursday: 7:30am-5:00pm
Friday: Closed