Forms and Patient Information

If you are a new patient for WLHC Primary Care services, please bring the Patient Information Sheet, the Payment Policy, and HIPAA Compliance Form signed and completed on your first appointment. 

If you are seeing one of our Integrative Providers, please bring there specific New Patient Intake Forms to your first visit.

If you have further questions about any of these forms, please feel free to contact Whole Life Health Care, at 603-431-6677.

	WLHC Family Practice / Primary Care (New Patients Please Print All Documents) - New Patient Demographic Form - Financial Policy - No Show/Cancellation Policy - HIPPA Privacy Notice - HIPPA Notification Form - Authorization to Speak/Release Information - Release of Medical Records
	Seacoast Acupuncture and Wellness - New Patient Intake Form
	Ayurveda for Life  with Jennifer Carlson - New Patient Intake Form (Health Information Form)
	Ayurveda for Life  with Jennifer Carlson - New Patient Intake Form (Body Typing)
	Ayurveda for Life  with Jennifer Carlson - New Patient Intake Form (Statement of Understanding)
	Essentia Botanica with Deborah Brett - Health History Intake Form
	Massage Therapy (Bodypeace) with Dawn Lipinski - New Patient Intake Form
	Mental Health Counseling with Lisa Spurling - New Patient Letter to Parents/Guardians
	Mental Health Counseling with Lisa Spurling - Adult New Patient Information Form
	Mental Health Counseling with Lisa Spurling - Consent to Treatment Agreement
	Natural Health Intuitive and Energy Medicine with Hilary McCann -  New Patient Intake Form
	Nutrition Therapy with Melissa Snow - Adult New Patient Intake Form
	Psychotherapy with Tammy Svenson - Consent to Treatment Agreement
	Psychotherapy with Tammy Svenson - Services Agreement for Collaterals
	Psychotherapy with Tammy Svenson - Patient Intake Form
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