CROSSROADS Family Medicine & Pediatrics (603) 856-8828
CROSSROADSFamily Medicine & Pediatrics (603) 856-8828

The first step in becoming a new patient at Crossroads is to download, complete, and return the 'New Patient Acceptance Request' form below.  Prior to submitting this form, check with your insurance company to ensure that at least one of the providers at Crossroads is in-network for your specific insurance plan.  Also keep in mind that Crossroads does not offer chronic opiate (narcotic) or benzodiazepine management.  This form can be dropped off, mailed, faxed, or emailed to the clinic at your convenience.  Feel free to call the clinic for more information.

***** IMPORTANT NOTICE *****  Crossroads is not currently accepting new adult patients whose primary coverage is Medicaid (or a Medicaid managed care plan).  This includes anyone applying for or with a pending Medicaid application.  We are still accepting pediatric patients with Medicaid.

Patient Acceptance Request Rev 20170601.[...]
Adobe Acrobat document [41.3 KB]

Once accepted as a patient at Crossroads, you will need to download, complete, and return all the forms included in the 'Annual Patient Packet' below.

Patient Packet Rev 20170601.pdf
Adobe Acrobat document [130.4 KB]
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© Crossroads Family Medicine, PLLC

Contact Us Today!

194A Pleasant Street, Ste 101
Concord, NH  03301 


Phone: 603-856-8828 603-856-8828

Fax: 603-856-8813

E-mail: email@crossroadsmednh.com