New Patients

Patient Forms and Directions to Tannersville Office

Your first visit to Dr. Jeffrey R. Wert & Associates - Family Dentistry establishes a vital foundation for our relationship with you. During the first visit, we make sure to obtain important background information, like your medical history, and give you time to get to know your doctor. To understand what to expect for your first visit to our practice, please review our website. You'll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more. There's also background information about our committed team. You can even save some time at your first visit by printing out and completing the patient forms in advance of your appointment.

Mission Statement:

To provide quality affordable dentistry in a relaxed and friendly manner

To fulfill this mission, we are committed to:

  • Listening to those we are privileged to serve.
  • Earn the trust and respect of patients, profession and community.
  • Exceed your expectations.
  • Ensure a creative, challenging and compassionate professional environment.
  • Strive for continuous improvement at all levels.

Patient Forms

Please print and fill out the applicable forms so that we can expedite your first visit:

For information regarding HIPAA or to read our current Notice of Privacy Practices, please click here.

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.


What To Expect

Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It also will help relieve any unnecessary anxiety you may be feeling. Educate yourself on your symptoms by reviewing the content on this Web site. Also, take some time to review our team page and familiarize yourself with our doctors and hygienists. We look forward to your first visit.

Driving Directions

South of Tannersville

  • Take Route 611 North and go through the light at Weis Market.
  • We will be on your left hand side before the next light.

North of Tannersville

  • Take Route 611 South and go through both lights at the intersection of Route 611 and Route 715.
  • We will be on your right hand side before the next light.