New Patient Forms

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Tel. 716.683.0891 | Fax 716.683.0579
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Lancaster Dental Associates, PC

We're thrilled and honored you have chosen to trust Lancaster Dental Associates with your family's dental health. As the home of lifestyle/family dentistry, we know that your schedule is already busy enough. You don't want to waste time sitting in our office filling out forms. So that we may provide services as soon as possible, please follow these three easy steps:

  1. Click on the New Patient Registration Forms below and print them out.
  2. Once you have printed the forms, complete them as follows:
    • Medical History (2 pages) – complete, sign and date on page two, and bring to your first appointment.
    • Notice of Privacy Practices (2 pages) – print and keep for your records.
    • Acknowledgement of Receipt of Privacy Policies (1 page) – print, sign and date where indicated, and bring to your first appointment.
  3. Then simply bring the completed forms (three pages) with you to your first appointment.

It's as easy as that! If you have any questions whatsoever, please call our office at 683-0891 and one of our Patient Care Associates (PCAs) will be glad to assist you.

Contact Us

Address Information

5755 Broadway
Lancaster, NY 14086

Contact Us

lancasterdental@roadrunner.com
Tel. 716.683.0891
Fax 716.683.0579