New Patient Forms
Congratulations! You have just taken the first step to better health. You will be receiving an email confirmation of your appointment immediately, and reminder as it gets closer.
Please check your spam folder if you do not see it in your inbox, and make sure to move it into your inbox and mark as “not spam” to ensure you receive our emails in the future. It’s also a good idea to add appointment-confirmations@appointmentquest.com and appointment-reminders@appointmentquest.com to your contacts, so that you don’t miss anything.
We request all patients to please download the New Patient Forms below and bring them with you to your first appointment. Please also bring a copy of your insurance card, if applicable.
If you are unable to fill out the forms ahead of time, please arrive 15 minutes early to fill them out in the office.
Important: Treatment cannot begin until all of your forms are received and signed.
Fertility Testing & Treatment History (fertility patients only)
Micorneedling Patients: Please contact our office before you book, to schedule a complementary consultation over the phone. Peterborough (603) 924-3400 or Portsmouth (603) 630-3629
Policies: If you have to change your appointment, please give us 24 hours notice so that we may give that appointment to a patient on our waiting list. No-shows and late cancellations incur a fee equal to the cost of an appointment. An exception to this is if you are experiencing any Covid symptoms, are otherwise ill, have an emergency, or there are dangerous driving conditions. We are unable to accommodate patients who are acutely ill, so if you are sick please stay home and contact your PCP. Thank you for honoring our policies.