Forms

Please select the forms below you would like to download. If you are coming in for your first visit with Dr. Miller, the first three forms would be the most useful to fill out. If they are received before hand, they will be reviewed prior to your visit. You can either scan and email your forms to drmiller@thelunacenter.com, fax them to (603)590-6318, or send by mail to 660 Central Ave. Ste 201A Dover, NH 03820. You can also arrive 20 minutes early to your appointment to fill out your paperwork at The Luna Center for Natural Health.

Thank you!

Attachment Size
Patient Information Form.doc 28.5 KB
Adult Intake Form.doc 35.5 KB
Consent to Treat .doc 25.5 KB
Authorization to Release Information.doc 35 KB
Notice of Privacy Practices 39.68 KB