Forms and Documents

Potential Client Forms:

This form is what we use to consider if a client is a good match for our practice.


This form must be submitted and reviewed before your first appointment can be scheduled.

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. 

New Client Documents:

This document contains information about this practice that anyone seeking treatment here should be aware of. 

This document contains information specific to your provider and your care.  Your therapist will go over the information with you in person at your first appointment.

Established Client Forms:

This form empowers your therapist to share confidential information with whomever you choose. 

Physical Address Only - No Mail 

Cocheco Mills

100 Main Street

Suite 111

Dover, NH 03820

Directions to Suite 111 can be found HERE.



T: (603) 343-2166

© 2017 by Alliance Mental Health.

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Office Hours

9 am - 5 pm  Monday - Friday


Some providers do offer after hours

appointments upon request.


Mailing Address:

PO Box 1592

Raymond, NH 03077