New Patient Forms

Thank you for your interest in our practice. We look forward to seeing you at your appointment. Below is a checklist of the things that need to be done prior to your appointment.

1. Change your primary care provider with your insurance company prior to your visit.

Both Amherst and Concord Sites: Please ask your insurance company to list Wendy L Wright as your primary care provider. If you have any problems with this, please ask your insurance to contact us at 603-249-8883.

2. Please print out and complete our Patient Registration Form prior to arriving. This will save you time at your initial visit. If you are unable to complete prior to visit, please bring along a list of your medications (dosage, frequency), any allergies and arrive 15 minutes prior to scheduled appointment for paperwork!

3. Bring your insurance card and co-payment to the visit.

4. Request your medical records from your previous provider using our Record Release Form. Please complete this form and mail to your previous provider as soon as possible.

5. Please print out the Release of Information Form and bring to your first appointment. Only the names listed on the Release of Information Form will be allowed to communicate with our office regarding your health care.

6. If you are visiting our office for a consult only, please be certain to obtain a referral from your primary care provider in advance.

7. Please review our Policies.

8. Please review our HIPAA Privacy Notice.

New Patient Form

Record Release Form

Release of Information

Policies

HIPAA Notice

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