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WellSpan Offices & Locations

WellSpan Medical Group Patient Forms

New Patient Paperwork

If this is your first time seeing a WellSpan Medical Group provider, please print out our new patient packet for your doctor visit and bring the completed forms to your first appointment. If you prefer to complete the forms at the office, please plan to arrive 15 minutes prior to your appointment.

Behavioral Health Paperwork

For new Behavioral Health patients, please print out and complete the adult new patient packet (age 18 years and older) or the minor new patient packet (age 17 and under) for your visit. In order to secure your appointment, completed forms will need to be received within two business days at the practice location where your appointment was scheduled. Should you have any questions, please do not hesitate to contact the practice directly.

Consent-to-treat Form

If your child is under the age of 18 and being escorted to an appointment at a WellSpan Medical Group office by someone other than a parent/legal guardian, a consent-to-treat form is necessary.  Please send this form with your child's escort to your child's appointment.

Request a Copy of Your Medical Records

If you would like to obtain a copy of your medical records, please direct your request to the WellSpan Release of Information Department using an Authorization to Use or Disclose Health Information form English Version | Spanish Version (PDF). Please note that many components of your electronic health record are available to you 24/7 on the secure MyWellSpan patient portal, so you might to check there first.

Advance Directives

In Pennsylvania, competent adults have the right to decide whether to accept, reject or discontinue medical care and treatment. There may be times, however, when a person cannot make his or her wishes known to a health care provider. For example, a person may be unconscious or too badly injured to tell his or her doctor what kind of care or treatment he or she would like to receive or under what circumstances that doctor should withhold care or treatment. In these cases, legal documents such as advance directives (i.e., living will and durable power of attorney) play critical roles in make sure your wishes will be followed.

Click HERE to learn more about advance directives and to download blank forms.

Controlled Substance Agreement

With the safety and wellbeing of patients and communities in mind, WellSpan Medical Group offices have changed how controlled drugs are prescribed and monitored. This effort includes the WellSpan Controlled Substance Agreement between the patient and his or her health care provider, reflecting a joint understanding of what is required for a controlled substance to be prescribed and used safely by a patient.  English Version  |  Spanish Version  (PDFs)

The agreement is part of WellSpan’s greater efforts to combat the negative effects of controlled drugs in the communities we serve. WellSpan recognizes that the Controlled Substance Agreement – and the requirements within the agreement – may be inconvenient for some patients. However, it is an important way for WellSpan to protect both the patients and the communities we serve from the negative impacts of these drugs. The physicians and advanced practice clinicians of WellSpan are committed to partnering with patients to help them achieve their health goals, and we appreciate patients’ understanding and cooperation as we work to combat the growing opioid epidemic in our communities.


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About the provider search

This search will provide you with WellSpan Medical Group and Northern Lancaster County (Ephrata) Medical Group primary care physicians and specialists. If we don’t have a WellSpan Medical Group physician to meet your criteria, the search will expand to include community physicians who partner with WellSpan Medical Group physicians through the WellSpan Provider Network or provide care to patients on the Medical Staffs of WellSpan’s Hospitals.


Schedule Your Next Appointment Online with MyWellSpan

Use your MyWellSpan patient portal any time to view available appointments, and pick the date and time that best suits your schedule.

Go to MyWellSpan

New to this practice?

If you don't have a WellSpan primary care provider and would like to schedule a new patient appointment with a provider who is accepting patients, just log into your MyWellSpan account, and go to the Appointment Center section. As you progress through the scheduling process, you will be able to see the offices that are accepting new patients in relation to your zip code. If you are not enrolled in MyWellSpan, go to, call 1-866-638-1842 or speak with a member of the staff at a participating facility to sign up. New patient scheduling not available at all practices/programs.

Already a patient at this practice?

If you already have a relationship with a WellSpan practice, simply log into your account, and go to the Appointment Center section. As you progress through the scheduling process, you will be able to schedule an appointment with any provider or practice that already counts you as a patient. Online scheduling varies by practice/program.