Patients Forms

To help get you into Smile Rite II sooner, Dr. K. Randy Martin suggests that patients prepare for their dental appointment. Our dentist in Carlisle, Pennsylvania, have provided the forms below to help our patients quickly get the care they need. Contact our office at 717-960-9969 if you have questions about your appointment or about the forms below.

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.