Online Forms

Cheshire Wellness Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.

• If you do not already have AdobeReader® installed on your computer, click here to download.
• Download the necessary form(s), print it out and fill in the required information.
• Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

To best address all your needs, all first time visitors are asked to fill out a Comprehensive Health Profile. This profile helps identify what areas need the most attention and what type of care would be the best fit for you.

Simply download the form, and fax it to us at: 603-357-5151 or bring it with you to your first appointment. Please email or call 603-357-5700 with any questions or comments to set up your first visit.

Download & Print Form