All required forms are accessible via our secure Patient Portal and can be submitted quickly and easily as fillable forms. If you are a new patient, please enroll in the secure Patient Portal via the “Patient Portal” button below to access these forms. Existing patients may also access the Patient Portal with the button below. Select the “Forms” tab to access and submit your forms electronically.

Patient Portal

Appointment Check-In Form

Please Check-In no earlier than 48 hours and no later than 24 hours before your appointment. A $15.00 fee will be applied if you need assistance with completing your Check-In. Checking in serves as appointment confirmation, provides a pre-visit health screening, and creates the treatment plan framework for your visit. Students: Complete only #1 below.

The Check-In form is located in your secure portal. You may also call in your Check-In to our office at 603-718-8328 and leave a voicemail if necessary. Your visit may be cancelled or rescheduled if you are unable to complete Check-In.

Date and time of your appointment:

1. Have you recently (in the last 2-4 weeks): 
    • been ill with a fever, cold, or flu-like symptoms?
    • had a runny nose, had sneezing, or had coughing?
    • been around anyone sick?
    • traveled to any place that is currently experiencing any type of infectious disease outbreak?
If “yes” or “maybe” to any of the above, please describe.
2. What would you like to address during this visit? And are there any additional health symptoms or concerns?
3. Recent medical visits, test results, new diagnoses, procedures, or vaccinations?
If “yes”, please describe.
4. Any changes to your supplements, medications, or self-care routine?
If “yes”, please describe.
5. Any new allergies, sensitivities, or intolerances — to foods, drugs, or environmental factors?
If “yes”, please describe.

Public Health and Safety:

Please sanitize your hands upon arrival. 
If you are sneezing, coughing, or have a fever, please stay home. 

DO NOT ENTER THE OFFICE IF YOU HAVE THESE SYMPTOMS: Sneezing, runny nose, congestion, scratchy throat, sore throat, cough, loss of taste or smell, fever, chills, shaking with chills, fatigue, malaise, new shortness of breath or difficulty breathing, new headache, new body aches or muscle pain; new skin changes or rash, new nausea, gastrointestinal upset, abdominal pain, vomiting, or diarrhea; delirium or confusion. Please use your secure portal or call 603-718-8328 to reschedule your appointment if you have any of these symptoms. Go directly home, seek medical assistance as needed, and always call 911 for emergency.

Face Mask Policy: Masks are provided and required if you have respiratory infection or symptoms including sneezing, coughing, and runny nose or if you have known recent exposure to someone with infection or symptoms of contagious illness including the common cold, COVID-19, RSV, flu, whooping cough, “stomach bug”, Norovirus, measles, tuberculosis, and Chicken Pox. Masks are encouraged when you visit if you are at risk of severe illness from respiratory infection. You are at risk if you are a senior adult, have a weakened immune system, have a chronic health condition (such as heart disease, lung disease, diabetes, and obesity), and if you are a medically fragile individual. Staff and students will wear masks during cold and flu season, typically between October-May.

Are you waitlisted for an earlier appointment?

Patients who have completed and submitted the paperwork and who are waitlisted for an earlier appointment will be given priority for earlier appointments that become available. Completing and submitting your paperwork ahead of time is evidence of investment in your own health and serves you best by allowing us adequate time for thorough review before your visit. Please enroll in or access your secure patient portal and submit your forms as soon as you can. We look forward to seeing you soon!