Download Forms.

For your convenience we have provided commonly used forms that can be downloaded and printed.

Locations

400 Nationwide Drive
Harrisburg, PA 17110
(717) 657-4400
(717) 657-4410

1664 East Chocolate Ave
Hershey, PA 17033
(717) 533-1587
(717) 520-5219

Before Your Visit.

Patient Information-Click Here
New Patients: Please fill our Patient Information form prior to arriving at our office. Filling out the form in advance may save time once you arrive at our office.

Patient Medical History-Click Here
New Patients: Please fill our Patient Medical History form prior to arriving at our office. Filling out the form in advance may save time once you arrive at our office.

Insurance Information-Click Here
All Patients: To ensure we have the most current information, please complete the Insurance Information form prior to arriving at our office.

After Your Visit.

Post Surgical Procedure Instructions
General Anesthesia-Click Here
Now that your oral surgery is completed, follow these procedures to make yourself comfortable, promote healing, and help prevent possible complications.

Post Surgical Procedure Instructions
Local Anesthesia- Click Here
Now that your oral surgery is completed, follow these procedures to make yourself comfortable, promote healing, and help prevent possible complications.

BILLING QUESTIONS??

For patient and insurance billing inquiries, please e-mail our Billing Department at billing@milleroral.com, or call the office at (717) 657-4400, option 3.  

 CANCELLATION POLICY

Please be advised that our office requires at least 24 hours notice to cancel or reschedule an appointment. 

If you do not give our office24 hours notice, you may be charged a $25.00 fee for missed appointment time which will need to be paid in full before your appointment can be rescheduled.