Becoming a Families First Patient

Families First is accepting new patients. Thank you for considering Families First for your health care needs, and welcome! Please follow the instructions on this page if:
1) You want to become a Families First Health Center patient. The Health Center is open to everyone -- men, women and children; infants to seniors; insured or uninsured, all income levels. We provide primary care and prenatal care. (Questions? Call 603-422-8208, press 1)
2) You want to become a Families First Dental Center patient. The Dental Center is open to all children and teens living in New Hampshire or Maine, and to senior citizens and veterans who live in or near Portsmouth. (Other adults must first be established primary-care or prenatal patients at Families First before using the Dental Center.) Questions? Call 603-422-8208, press 3.

Please print out the forms by following the links below, or call us at 603-422-8208 (press 1) and ask to have them mailed to you. Also, feel free to call anytime if you have questions.

Paperwork before scheduling a Primary Care or Dental appointment

Families First can help if you have questions or need help completing paperwork: Call 422-8208 ext. 242.

Paperwork before scheduling a Prenatal appointment

  • Prenatal Intake Form (11 pages). The form asks you to sign a statement that you have read and understand the documents on pages 18-30 of the Patient Handbook.
  • Copy of Medicaid or insurance card, if you have this coverage. (We can photocopy for you.)

For help filling out paperwork or other questions, call 422-8208 ext. 142.

If you’re uninsured . . .

Did you know you may be eligible for free or subsidized health insurance? Families First would like to help you explore your options for getting health insurance. Please call Elaine at 603-422-8208 ext. 188 for personal assistance, or click here for other resources.

Meanwhile, we offer a sliding fee scale, based on income, to patients who are uninsured or underinsured. (If you later become insured, we hope you will remain a patient at Families First. Families First is here to serve both insured and uninsured patients.) To apply for a sliding-fee discount, please provide the following:

  • Sliding Scale Application (also included as page 4 of the Primary Care/Dental Intake Form posted above)
  • Proof of all types of income that you and your spouse receive, including salaries and wages, Social Security, retirement, business, welfare payments, child support, alimony, disability and any others. For each type of income, submit one of the following:
     - Most recent tax return
     - Pay stubs
    Unemployment check stubs; or
     - Schedule C (Profit & Loss from Business)

    For help filling out paperwork, call 422-8208 ext. 242.

Please mail the paperwork back, or drop it off at Families First anytime the Health Center is open (Mondays, Tuesday, Thursdays and Fridays from 7:30 a.m. to 5 p.m., and Wednesdays 7:30 a.m. to noon and 1:30 to 5 p.m.) After we receive your paperwork, we’ll schedule your first appointment. We will also tell you the amount of your sliding fee scale payment if you applied for the sliding fee scale.

On your first medical visit

  • Please arrive 10-15 minutes early to finalize paperwork.
  • Bring your copayment if you have insurance that requires one, or your sliding fee scale payment if you are using our sliding fee scale.
  • If you would like to use our Patient Portal to request appointment times, medication refills or referrals, or to update your contact info in your medical records online, please request a password from any staff member in-person at Families First.
  • If you need child care during your appointment, click here.