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 for assistance with completing your Check-In. Checking in serves as your 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 us 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:  Face masks will always be provided, and are encouraged for those that remain at the greatest risk of severe illness from respiratory infection including senior adults, people with weakened immune systems, people with chronic health conditions (such as heart disease, lung disease, diabetes, and obesity), and medically fragile individuals.
Effective 4/01/2023, face masks are optional for visitors, non-infectious patients, and vaccinated staff and students, with some exceptions; face masks will be required in our facility:
  • For anyone with respiratory symptoms including sneezing, runny nose, or coughing
  • For anyone with respiratory infection, including COVID-19
  • For anyone who has been recently exposed to COVID-19
  • For unvaccinated staff and students
  • Annually during circulation of acute respiratory illness in New Hampshire (“cold and flu season”), within a predetermined time frame usually spanning 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, and no later than 24 hours before your appointment.

We look forward to seeing you soon!