Middletown Dental Services

Patient Resources

(Click on a Clipboard Link Below for the Forms You Need)

For your convenience, we have grouped together the most commonly used forms and resources, below. Simply select the type(s) of forms to complete by clicking on the applicable clipboard icon. If you need assistance reading or understanding the forms, please contact our Premier Dental of Carlisle office.

New Patient Intake Forms

If you are a new patient who has not yet been seen at our office, please click on the “New Patient” clipboard link and complete/submit the patient information forms. The forms will open in a new tab and be submitted securely to our office. Thank you.

HIPAA Privacy Notice

We maintain a HIPAA (Health Insurance Portability and Accountability Act) compliant privacy policy. Please click on the “HIPAA Notice of Privacy Practices” Clipboard to view, download and print our Privacy Policy. The forms will open in a new tab and be submitted securely to our office. Thank you.

Financial Policy

To see our payment policy or how we help you file an insurance claim, please click on the “Financial Policy” Clipboard to learn about payment options and to enjoy discounted billing by joining the PDC Dental Membership Club. Thank you.

What Our Patients are Saying about Us

      EXCELLENT  
   Based on 197 reviews 
    
 
 
 
   
 
 
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   tim gehron 
 8 October 2026
 
 
  Always kind and compassionate. At my age prices are somewhat salty.
  
 
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   Karilyn Weidner 
 7 October 2026
 
 
  Great job!
  
 
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   Janelle 
 6 October 2026
 
 
  Exceptional office & staff
  
 
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   Gary Oswald 
 5 October 2026
 
 
  Very professional and personable
  
 
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   Sharon Simpson 
 5 October 2026
 
 
  Outstanding work.  I was so worried.   But my treatment was wonderful.   No pain.  I am set.  Thank you so much.
  
 
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   Gene De Laney 
 5 October 2026
 
 
  Prompt and friendly service as always
  
 
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   Spongedeb Fatpants 
 2 October 2026
 
 
  Everyone is so friendly and personable! And they play awesome music too 😉
  
 
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   Stephen Kucera 
 1 October 2026
 
 
  This place is awesome. Had our first two visits here over the past 2 days with the kids. Riley was our Hygienist and she was phenomenal. She was especially great with my son who was a bit nervous. The entire staff was great. Highly recommended.
  
 
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   Peg Bordner 
 23 September 2026
 
 
  Best dentist ever, he's very thoughtful and has the patience of a saint. The girls at check in /out are are very people friendly, the hygienist are very professional and easy going. You couldn't find a better team than this. 🦷⭐️⭐️⭐️⭐️⭐️
  
 
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   Sitora Anabas 
 23 September 2026
 
 
  Dr. Selcher is the best. May God grant him good health and long life so I never have to look for another dentist.