THE COUNSELING CENTER OF NASHUA

Confidential, Professional, Personal Care When You Need It



Please complete this history form at least 48-72 hours before your appointment, and if not 48-72 hours in advance, please understand that it may not be routed to your Doctor prior to your first appointment.




FOR ADULTS -- [CLICK HERE]-- TO COMPLETE A CLINICAL HISTORY FORM PRIOR TO YOUR FIRST APPOINTMENT TO SEND CONFIDENTIAL INFORMATION TO YOUR DOCTOR



FOR CHILDREN OR TEENS -- [CLICK HERE] -- FOR PARENTS OR CAREGIVERS TO COMPLETE A CLINCAL HISTORY FORM PRIOR TO YOUR FIRST APPOINTMENT TO SEND CONFIDENTIAL INFORMATION TO YOUR DOCTOR


(Click here to view our HIPAA notice of privacy practices)

OFFICE LOCATIONS

One Main Street
Nashua, NH 03064
Phone: 603-883-0005
Fax: 603-883-0007
Directions
Map to Office		 Hitchcock Clinic Family Practice
294 Daniel Webster Hwy
Merrimack, NH 03054
Phone: 603-883-0005
Fax: 603-883-0007
Directions
Map to Office 		697 Union Street
Manchester, NH  03104
Phone:603-627-3111
Fax: 603-883-0007
Directions
Map to Office 		234 Lafayette Road
Hampton, NH 03842
Phone: 603-436-0032
Fax: 603-883-0007
Directions
Map to Office 		Hitchcock Clinic Family Practice
321 Derry Road
Hudson, NH 03051
Phone: 603-883-0005
Fax: 603-883-0007
Directions
Map to Office 		125 Londonderry Tpke
Hooksett, NH 03106
Phone: 603-627-3111
Fax: 603-883-0007
Directions
Map to Office