IF YOU HAVE YOUR MEDICAL RECORDS AND WOULD LIKE TO SECURELY UPLOAD THEM TO DMC, PLEASE CLICK HERE.
Below are forms you may need as a DMC Primary Care patient.
If you have questions or are looking for information not listed here, please call us at 603-537-1300. Our Medical Records main fax number is 603-537-1355.
New Patient Forms
Adult (18+) New Patient Packet
Pediatric (0-17 years) New Patient Packet
Looking for a specific form?
- Medical Records Release Form Print E-Sign
- FollowMyHealth Portal PROXY Access Print E-Sign
- General Consent for Treatment Print E-Sign
- Physical Evaluation History Form Print E-Sign
- Financial Policy Print E-Sign
- Patient Code of Conduct Print E-Sign
- Notice of Patient Privacy Practices Print
- No Show Policy Print E-Sign
- Preferences and Consent for Communications Print E-Sign
- Preventative Health Visits – Scope of Insurance Print E-Sign
- Medical Records Release Form Print E-Sign
- Consent for Non-Parent/Guardian to Accompany a Minor to Medical Appointment Print E-Sign
- Consent for Minor Child to Attend Medical Appointment Unaccompanied Print E-Sign
- FollowMyHealth Portal PROXY Access Print E-Sign
- General Consent for Treatment Print E-Sign
- Physical Evaluation History Form Print E-Sign
- Financial Policy Print E-Sign
- Patient Code of Conduct Print E-Sign
- Notice of Patient Privacy Practices Print
- No Show Policy Print E-Sign
- Preferences and Consent for Communications Print E-Sign
- Preventative Health Visits – Scope of Insurance Print E-Sign