Become a Patient:
Who can use this program?
What should I do first?
- If you have a printer, you may fill out this Prenatal Intake Form (.pdf). Or we can give you one to fill in here in our office.
- Read these pages from our Patient Handbook (.pdf)
- Print and sign the form.
- Mail or bring the form to:
C/O Prenatal Social Worker
100 Campus Drive
Portsmouth, NH 03801
If you have questions, call our prenatal social worker at 603-422-8208 (press 1, then 3142)
- Our prenatal social worker will call you to schedule your appointment. Let her know if you will need child care or translation.
- Arrive 5-10 minutes early to finalize paperwork. Bring your forms if you haven’t mailed them in. Ask for a Patient Handbook.
- Bring a list of the medications you take, or the actual medications.
- Bring your insurance co-payment or sliding- fee scale payment, if any.