White Mountain Community Health - Affordable Health Care, Conway NH
Open Monday through Friday
8:30am to 4:00pm
(603) 447-8900

Patient Forms and Policies

New patient forms and policies

Print these forms and fill them out before your first appointment. You'll also need to check the patient demographic form and update it with any changes at every appointment.

Record releases

Use these forms to transfer medical records to and from the health center. You'll need to print the form, fill it out, then fax it to (603) 447-4846, mail it to us at PO Box 2800, Conway, NH 03818, or drop it off.

Sliding fee scale application

Please call us at 447-8900 if you have any questions about our forms and policies.