Patient Forms - Parkland Physician Services of Salem
We have moved to a new office as of March 18, 2013. Our new office is conveniently located at 31 Stiles Road, Suite 2100, Salem, NH. Our phone and fax numbers remain the same.
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Patient Forms

New Patient Registration Forms

If you are a new patient you may download our registration forms in advance and bring the completed forms with you when you come for your appointment.

Patient Registration

Patient Consent

Patient Financial Responsibility Policy

Medical Records Release Authorization (as needed only)

Privacy Notices

Notice of Privacy Practices

Aviso Sobre Las Practicas De Privacidad

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Hospital Affiliation