Find sample forms and letters to support documentation, employment, general liability and patient care. Search Sample Forms.Dentists must obtain informed consent for every treatment you propose and perform on patients or from the patient's legal guardian or decision-maker. The letter is only required when contracting with a new dentist. The request must be mailed to: Division of School Health, 30 Kline Plaza, Harrisburg, PA 17104. Find all of the forms needed for claims, authorizations and more. Claim Forms For DeltaCare® USA claims and encounters. BLE retrospective requests must be submitted no later than 60 days from the date AmeriHealth. There are two options for submitting health care complaint forms – either an online electronic complaint form or a printable PDF form. How do I fill this out?