Jack D Steele, DMD Family Dentistry in McConnellsburg and Dry Run, PA

Jack D Steele DMD Family Dentistry

New Patient Forms

We are happy to offer our patient forms online. Please feel free to print and fill them out at your convenience before your visit.


New Patient Registration

Please download, print and complete this form before your first dental appointment.
Download New Patient Registration Form (66 KB)


Financial Policy

This notice describes financial policies.
Download Financial Policy Form (229 KB)


Notice of Privacy Practices

This notice describes how health information about you may be used and disclosed and how you can get access to this information.
Download Notice of Privacy Practices (229 KB)


 
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