Forms
Registration Form (can be completed in advance of your first visit, PDF)
Obtain Records (from any provider/institution to Dr. Zwaan, PDF)
Release Records (or exchange information from Dr. Zwaan to other provider, PDF)
Practice Policies (an updated version is on the “about us, our practice” tab, PDF)
Private Contract (for Medicare patients. Fees on this form have changed, PDF)
Administrative Fee (needs updating. access fee now $200/$300 per year, PDF)
HIPAA Notice (if you are interested in privacy rules, PDF)
Diabetes Journal (used at each diabetic follow-up visit, PDF)
Additional forms are available on the secure patient portal.
General Info
Fax: 603.658.3105
Office Location
Exeter Executive Park
19 Hampton, Road
Suite One
Exeter, NH 03833
Hours
For lifelong health and wellness
Same Day Appointments Available.
BOARD CERTIFIED FAMILY PHYSICIAN
SENIOR AVIATION MEDICAL EXAMINER
Give Us a Call
e-mail Dr. Zwaan
Office Location
19 Hampton Road, Suite One
Exeter, NH 03833
Secure Patient Portal
Established patients can log into the Updox portal to:
- send and review messages
- review reports
- request refills and referrals
- request, confirm or cancel appointments
- make payments