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WellSpan Offices & Locations

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. 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.



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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.