Free Phone Consultation: 603.718.8328
All forms required of new patients and established patients 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 link below to access the forms. If you have enrolled and have an existing Patient Portal account, you may access it below. Select the “Forms” tab to access and submit your forms electronically.
Check-In Form
Check-In is required within 48 hours and no later than 24 hours before each scheduled appointment and is best completed via the secure portal. Answers to Check-In questions below may be called in if you are unable to access the secure portal. Voicemail is available 24/7 at 603-718-8328. Your Check-In serves as a pre-visit health screening and helps us to provide you with complete care during your visit. You may incur an additional charge for assistance with Check-In and your visit may be cancelled or rescheduled if Check-In is unable to be completed.
1. What would you like to address during this visit?
And are there any additional recent symptoms or concerns affecting your health?
Please let us know ahead of time so we can prepare in advance of your visit and focus on you during your appointment.
2. Recent medical visits, test results, vaccinations, procedures, new diagnoses, new medications or supplements since your last visit:
You may also upload documents via your secure portal.
3. Any new sensitivities or allergies (to foods, drugs, or environmental factors) since your last visit?
4. Have you recently been ill with a fever or flu-like symptoms, been around anyone sick, or have you recently traveled to any place that is currently experiencing any type of infectious disease outbreak.
If “yes” or “maybe”, please describe:
5. Do you need refills on anything prescribed from this office?
Let us know ahead of time and we’ll have it ready for you.
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, and no later than 24 hours before your appointment.
We look forward to seeing you soon!