New Patient Online Registration Form

For New Patients to Lehigh Oral & Maxillofacial Surgery:

a patient completing online forms at Lehigh Oral and Maxillofacial Surgery

Please fill out the online Patient Registration form PRIOR to your arrival. This will speed your check-in process on the day of your consultation.

If you have questions about any of the forms, please give us a call at (610) 435-6161 and our staff will be happy to help you.

•	Patient Registration

GET IN TOUCH

Request Appointment

Allentown Office
1251 S. Cedar Crest Blvd. #311
Allentown, PA 18103

Call (610) 435-6161

Hellertown Office
800 Main St #105
Hellertown, PA 18055

Call (610) 435-6161