To help achieve success at the initial visit, we have provided resources to help you and your child prepare.


To help you and your child prepare for the initial visit, please review answers to frequently asked questions.


NEW patients - please print and complete one of the following prior to the initial evaluation:

Patient Case History - Birth to 2 years, 11 months

Patient Case History - 3 to 10 years, 11 months 

Patient Case History - 11 to 18 years


We would appreciate the opportunity to review the completed form prior to the first appointment. You may do one of the following:

  • Fax it to (603) 777-1893
  • Return it by mail to Pediatric Rehabilitation, Exeter Hospital, 5 Alumni Drive, Exeter, NH 03833 –If your appointment is two or more weeks out from the day that you mail it back to us, this might be an option for you. Please allow ample time for us to receive it prior to your appointment.
  • Hand deliver to 212 Calef Highway, Epping, NH
  • If necessary, you may bring it with you to the evaluation