Make an Appointment: (603) 332-8000 | [email protected]

  • Client Forms

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    If you are new, please feel free to fill out these intake forms before our first session. These forms can also be filled out during the first session.

    If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

     

    Mental Health Release of Information: you can download this form here in the link below or ask for it to be sent to you by your therapist to electronically complete in the client portal.  IMPORTANT: when you have completed your form you need to email or fax this to your provider at the office.

    Release of Information Form – Mental Health

     

    Nutrition Services Release of Information: you can download this form here in the link below or ask for it to be sent to you by your therapist to electronically complete in the client portal. IMPORTANT: when you have completed your form you need to email or fax this to your provider at the office.

    Nutrition Services Release of Information

    PROFESSIONAL RECORDS

    We maintain a file for each client. If you want communication with another medical provider you see or a copy of your records, please request and complete a PHI release with your clinician. As a client, you are entitled to a copy of your records for a fee that covers copying and administrative costs. If you wish to see a copy of your treatment records we recommend you review them with us so that we may discuss the contents.