Forms from the Mechanicsburg, PA Oral & Maxillofacial Surgeon Office

Prefer to complete your health history from the convenience of your home? Simply click on and print Health History, fill it out in blue or black ink and bring it with you to your first appointment.

Health History 1
Health History 2

Have medical records you want sent to us? Click on Authorization to Release…, fill it out and send the completed form to the healthcare provider who holds your records.

Authorization to Release Healthcare Information

Company Information

  • Central PA Oral & Maxillofacial Surgeous LLC
  • 220 Cumberland Parkway, Suite 6
  • Mechanicsburg, PA 17055
  • Phone: (717) 697-7000
  • Fax: 717-697-5908
  • E-Mail: [email protected]

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