Patient Forms & Resources

Forms to Download

New patient paperwork - Adult
New patient paperwork - Minor
Request copy of medical records / release of information

Information for Patients

Health Questions

Please contact our office during regular business hours for general health and non-urgent questions. You may also send us secure messages 24/7 using your MyWellSpan account. We aim to respond to messages within 48 hours.

After-hours Emergencies

For crisis/emergency situations, WellSpan Behavioral Health offers 24-hour crisis counseling that individuals may access either through a toll-free telephone number or face-to-face interview. If you are experiencing a life-threatening situation, dial 911 or go to the closest emergency department immediately.

Request a Prescription Refill

For prescriptions filled originally at one of WellSpan's retail pharmacies, you can request refills online through your MyWellSpan account.

For prescriptions filled at non-WellSpan pharmacies, please contact your pharmacy directly. If you need a refill authorization, please call the office during regular business hours 24 to 48 hours before you need it.

Please note we are unable to prescribe any new medicines by telephone.

Prepare for Your Appointment

Please give us as much notice as possible if you are unable to keep a scheduled appointment so we can offer that time to another patient. You may cancel your appointment online 24/7 through your secure MyWellSpan account.
If you have an immediate need to be seen for illness or injury, we suggest calling us as early as possible. You can use your secure MyWellSpan account 24/7 to check for same-day/next-day appointment openings.
Please be prepared to give our staff a complete list of issues you would like to address during your appointment. This will allow us to schedule the appropriate amount of time to address your needs.
Bring all medications in their original containers to appointments with you so we can verify your medications list.

Pay Your Bill Online

You can pay your bill online on WellSpan's secure payment portal. If you have questions about you bill, please contact our billing department directly for assistance.