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New Patient Registration

**Wakefield Family Medicine is not currently accepting new patients. If you would like to be added to our waiting list, please complete the form below.  Thank you.**

 

Step 1: Complete Online Registration Form

Thank you for registering at Wakefield Family Medicine. Once your registration forms and medical records arrive, we will contact you to make your first appointment. Please expect 4-6 weeks. If you need care in the meantime, please contact our office directly. 

Step 2: Complete, Sign, and Return (mail, fax or email) all of the following forms below:

New Patient Registration

Medical Release

Adult Health History

Financial Consent

Mail: 131 Meadow Street. Sanbornville, NH 03872

Email: generalmailbox@wfm-nh.com

Fax: 603-871-8285

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