Forms & Documents

Here are downloadable forms and documents for the convenience of our medical office partners and clients. Please call us with any questions.

Patient Referral and Face to Face Documentation Form
This form is newly updated and combines the referral and “face to face” form previously two documents.

Long Term Care Referral Form

Home Care Client Rights and Responsibilities
Home health care providers are required by New Hampshire Law (RSA-151) to provide each client or client’s legal representative with this written copy of their rights and responsibilities in advance of or during the initial evaluation visit and before initiation of care.

Privacy Practices

Community Benefits Report
All New Hampshire health care charitable trusts are required to develop community benefits plans to ensure that they are working to identify and address the unique health care needs of their community. 2020 report will be available soon – check back later.