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Richard M Berg DDS PC | Patient Forms in Lititz


54 Copperfield Circle | Lititz, PA 17543-9483
Phone: (717) 627-3113 

New Patient Forms

To make it convenient for you, we have made our patient forms available online. Please click on the link below to download the forms so you can fill them out prior to your first appointment. Don’t forget to bring them with you!

Please check the box next to “Fit to Page” in the options section of the print screen prompt before selecting the final print button. If the entire documents are still not printing, then please adjust your printer’s side margins in your Printer Settings.

Patient Responsibility Form

Notice of Privacy Practice



Lititz Dentist | Patient Forms. Richard Berg is a Lititz Dentist.