We are excited that you are choosing Mercersburg Family Dentistry for your dental care. Our staff is happy to schedule you an appointment. If you are having dental pain, please do not fill out the information below, but instead call the office directly at 717-328-5700.

New Patient Application

If you are joining our dental family for the first time, plan ahead and download our new patient application forms. Please print, fill out to the best of your ability, and bring it with you to your appointment. This will allow us for efficiently see you in a timely manner and also allows you time to complete the requested information.

  1. Patient Health History (pdf)
  2. HIPAA (pdf)
  3. Office Policy (pdf)


Request Your Appointment Below