Interested in becoming a patient at Goodwin?
People seeking Primary Care, Pediatric Care, Prenatal Care, or Dental Care will need to complete our new patient intake packet:
To fill out the intake packet electronically:
To fill out a hard copy of the intake packet:
- Download the intake paperwork here
- Either scan it and email it to Gmail@GoodwinCH.org, or mail it to: Goodwin Community Health, 311 Route 108, Somersworth, NH 03878, or fax the forms to (603) 749-2748.
- Questions or to request the intake packet by mail: 603-749-2346
Once the patient intake packet in complete, there are a few more steps for new Dental and Prenatal patients:
- Complete The New Prenatal Patient Packet and Call 603-749-2346 to schedule an appointment.
- Currently, the Goodwin Dental Center is not accepting new patients except for dental emergencies.
- If you experiencing a dental emergency and are new to Goodwin Community Health, use this intake packet.
- If you are already a patient at Goodwin Community Health but have never used dental services before, use this intake packet.
Behavioral Health (Counseling)
- Counseling is available if you are a primary care patient or previously enrolled in the IOP (Intensive Outpatient Program) at Goodwin Community Health.
- Ask your primary care provider at Goodwin to refer you to a counselor.
Next Steps After We Receive Your Paperwork
If you have been seen by other providers, it is important that we have access to those records. Please fill out the medical release form. Please fill out 1 for each practice where you have received care.
Once registration has been received, someone will reach out to you within 5 days of receipt to schedule your first appointment.
After you complete the new patient registration form, someone from Goodwin will contact you to discuss helping you access the care you need with the right provider. During this visit, you will have the opportunity to ask your provider any questions and go over any concerns you may have.
Helpful new patient hints:
- At your first visit, please plan on bringing all prescription bottles with you.
- Don’t forget to bring your insurance card or proof of income(4 weeks of pay stubs or income tax form 1040)
- Read our Patient Handbook before your first visit
- Read about Our Providers.
- Once you are a patient you are given a PIN to use on our Patient Portal
- If you are currently uninsured, you can also schedule a FREE meeting with one of our Insurance Enrollment Specialists. You may be be surprised at the programs and discounts you are eligible for! To contact our enrollment team, email Enroll@GoodwinCH.org or call 603-749-2346 x2556.
Additional Patient Forms and Resources:
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Goodwin Community Health Center receives health and human services funding and are Federally deemed with respect to certain health care claims, including malpractice claims for its self and its covered individuals.
It is the policy of Greater Seacoast Community Health to treat all employees, patients and other service users equitably and not to discriminate based on race, color, religion, national origin, age, sex, sexual orientation, gender identity or expression, or disability.