Home
History
Medical
Massage
Counseling
Teaching
Prayer
Vision
New Creation Events
Where To Stay
Area Events
Opportunities
Need HELP?
Friends of NCHC
TICKS
Forms
Office Hours
Urgent Care Centers
Contact Us

Forms

  • Insurance referral forms (to see a specialist or receive a service) -  to ensure that we have been able to process them correctly with your insurance company.

    Insurance that requires a referral please fill out and return this form: General Referral Form.

    Please submit ALL information on this form by printing the above document and faxing it to 603-642-6701, dropping it off or Emailing it to office@newcreationhc.org with ALL the information completed.  Failure to complete may result in a delay of your referral and causing you to have to pay for you specialist visit.

 

  • Medical Release Form (to have a copy of your records sent somewhere) -

    If you have left our practice we recommend that you request a copy of your records to be picked up or sent to yourself.  We suggest this as it is our office policy to only provide your record once free of charge, subsequent requests will be charged a fee per page.  For example if you leave our practice and request that your records be transferred to your new PCP, Dr. X.  We will copy and send your records to Dr. X.  If you become unhappy with Dr. X or he/she leaves or closes their practice or anything else happens that results in you needing to request another copy of your records we will charge a fee per page for your record to be copied.  However if you request your records to go to yourself you can make as many copies as you wish to go to as many doctors as you wish over your lifetime giving you better continuity of care.  Please fill out our MEDICAL RELEASE FORM and submit it to our office.  Allow 14 business days for your request to be completed.

    If you are a current patient of the practice, and are not leaving our practice, but you need some or all of your records released to another entity (insurance company, research study, etc) and that entity has not asked you to sign a medical release form please fill out our MEDICAL RELEASE FORM and submit it to our office.

 

 

"Anyone who believes in Christ is a new creation. The old is gone! The new has come!  It is all from God. He brought us back to himself through Christ's death on the cross. And he has given us the task of bringing others back to him through Christ.  God was bringing the world back to himself through Christ. He did not hold people's sins against them. God has trusted us with the message that people may be brought back to him.  So we are Christ's official messengers. It is as if God were making his appeal through us. Here is what Christ wants us to beg you to do. Come back to God!  Christ didn't have any sin. But God made him become sin for us. So we can be made right with God because of what Christ has done for us."
~2 Corinthians 5:17-21 New International Reader's Version