Counseling, Consultation & Evaluation

New Patient Intake Paperwork

If you have spoken with our staff and are ready to complete our intake paperwork, please use our downloadable forms* to do so. If you are interested in receiving more information about our practice please call our office at 603-238-3149. 

New Patient Intake Paperwork (Complete) 


*If you are suffering from symptoms of depression, anxiety and/or an eating disorder please complete the associated pretest when completing our intake paperwork.

Please bring all completed paperwork to your initial appointment or send to