Patient Information & Forms
New Patient Form
Before your first visit to Daschbach & Associates, please take a moment to download and fill out this form.
Health History
Before your first visit, please download and complete this form. Bring it with you to your appointment.
Financial Agreement & Insurance Information
Download this form to read the list of insurance companies Daschbach & Associates works with.
New patients, please fill out this form before your first visit.
HIPPA Forms
Please complete and sign both of these forms and bring them to your first appointment.
Hours
| Monday | 8:30AM – 5:00PM |
| Tuesday | 8:30AM – 9:00PM |
| Wednesday | 8:30AM – 5:00PM |
| Thursday | 8:30AM – 9:00PM |
| Friday | 8:30AM – 5:00PM |
| Saturday | 8:30AM – 1:30PM |
| Sunday | Closed |
We are located across from the Bergey Car Dealership on Godshall Road.
Call Us
215-721-8811
Fax Us
215-721-5393
Email Us
reception@daschbach.com
Office Location
390 Harleysville Pike, Souderton, PA 18969
I can do all things through Christ who strengthens me
Philippians 4:13