Client Forms
Please download the forms for the specific service, fill them out on your computer (or by hand), print them, and bring with you to your initial appointment. Alternatively, a hard copy of the forms can be mailed or emailed to you to sign. (Please note that these forms may not download to your mobile device).
First, please complete a separate release form for each individual from whom we can request information (e.g., teachers, therapists, physicians) and/or to whom we can release results of the evaluation or treatment. Additionally, please complete the Constant Contact release form to receive information about upcoming events (e.g., presentations), clinical service offerings, and noteworthy discussion of articles regarding behavioral health, neuropsychology, psychotherapy, education, and other relevant issues.
Release Forms
Constant Contact Email Release Form
Please note our provider forms are not currently available. If you need a specific form please either call the office, (603) 433-0800 or email our office manager, lhauthaway@portsmouthneuro.com.
Select a Provider:
Dr. Rubin's Forms
Child Psychotherapy
Child Testing
Adult Psychotherapy
Adult Testing
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