White Family Dental
				
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Patient Info

Thank you for Trusting Us!

 

Patient Forms

A lot of us like to read and complete forms in the comfort of our homes. Please click on each of the links below so you’re ready for our appointment. If you have any questions, feel free to call us or drop us a note. We’re looking forward to seeing you!

  • Patient Information (PDF)
  • Health History (PDF)
  • Notice of Privacy Practices (PDF)
  • Acknowledgement of Receipt of Privacy Practices (PDF)

Smiles for Life

From March through June, we professionally whiten teeth to raise money for seriously ill, disabled, and underprivileged children in our local community and around the world. 100% of the cost of your whitening goes to helping kids.

Get your appointment scheduled today!

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    ELIZABETHTOWN - (717) 367-1336
    MANHEIM - (717) 879-9700
    MASONIC VILLAGE - (717) 366-2466
    717-367-1336




      • Home
      • Our Services
      • Cosmetic Dentistry
      • Dental Crowns and Bridges
      • Dental Implants
      • Dental Veneers
      • General Dentistry
      • Invisalign
      • Root Canals
      • Sedation Dentistry
      • Snoring and Sleep Apnea
      • Teeth Whitening
      • Under Armour Performance Mouthwear
      • Patient Info
      • Blog
      • Contact Us
      • Accessibility
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