Interested in becoming a new patient?

Please print out our new patient packet and complete it.  Once completed, please return the packet to our office via drop off, email, fax, or mail.  Once we have all of your information entered into our system, you may schedule a new patient appointment.

Adult New Patient Packet

Adult Medical History, Registration Form, Financial Policy, Notice of Privacy Practices Acknowledgement, Insurance Submission & Payment Authorization, Record Release Authorization

Click here for our Adult New Patient Packet

Pediatric New Patient Packet

Pediatric Medical History, Registration Form, Financial Policy, Notice of Privacy Practices Acknowledgement, Insurance Submission & Payment Authorization, Parent/Guardian Authorization, Record Release Authorization

Click here for our Pediatric New Patient Packet

Record Release Authorization Form

Click Here for our Record Release

Notice of Privacy Practices (HIPAA)

If you do not have a completed HIPAA form on file with our office, please follow the second link to this form.  Please complete it and return it to our office, so that we have updated information on your account.

Click here for our HIPAA Policy

Click here for our HIPAA Form

 

 

 

In emergency situations:

After hours, an on call doctor is always available and will return your calls as quickly as possible.
Phone: 717-292-3168

Location & Contact

Davenshire Medical Center
3740 Carlisle Road
Dover PA, 17315
Phone: 717-292-3168
Fax: 717-292-3479
e-mail: info@davenshiremc.com

Office Hours:

Monday: 8:00am – 7:30pm
Tuesday: 7:00am – 7:30pm
Wednesday: 8:00am – 7:30pm
Thursday: 9:00am – 5pm
Friday: 8:00am – 4:00pm