Patient Registration

Thank you for choosing Enduring Smiles. We look forward to taking care of your dental needs.

In order to streamline your first visit to our office, click the link below to fill out the new patient forms and HIPAA Privacy Forms.

• Click here to fill out the forms via the website

To transfer x-rays from a previous office, please fill out and submit the following form to your previous practice.  

• Click here to download Patient Transfer Form.

When you arrive for your appointment, your paperwork will already be filled out and you can go in for services without waiting. Please call our office at Media Office Phone Number 610-892-9088 to make an appointment and if you have any questions or need assistance filling out your forms.