Patient Information & Forms

Patient Information and Forms

Pre-Visit Information

Thank you for choosing Manchester OB/GYN Associates. To help ensure your visit goes smoothly, we have gathered all the necessary forms and information you will need in one location. 


Please make sure to read all the other policies as well.
Disclaimer and Privacy Policies Your Rights and Protection Against Surprise Medical Bills

Release of Health Information

  • If you are our patient and would like to request your medical records, please click on the link below to complete your request for medical records. You will be required to provide a valid email address and a government-issued ID.
Patient Record Request Third Party Record Request

FMLA/Disability Submission for Patients and Requesters

FMLA/Disability Request
  • What is Sharecare, and what exactly do they do?

    Sharecare is a health information management company contracted with Manchester OB/GYN Associates to provide services, including the completion of Disability and FMLA form paperwork.

  • How do I submit my FMLA or Disability paperwork?

    • Log into portal

    FMLA/Disability Request

    • Return the form to the practice

    • Fax form to (603) 622-8677


  • Is there a fee to have my forms completed?

    Yes, there is a pre-payment fee of $35 for the first form plus any applicable sales tax.

  • If I need another form completed to continue my disability claim, will I have to make another payment?

    Yes, a pre-payment fee of $35 per form for each consecutive or subsequent FMLA or Disability form regarding the same qualifying condition and claim.

  • How can I pay for my forms?

    Pay Online:

    • Suppose you have provided a valid email address on your authorization form. In that case, you will receive an email notification with a payment link that will direct you to pay on the Sharecare payment portal website.

    • If you did not provide an email address on your authorization form or cannot locate the email notification, you could pay online. You will need your Request ID to make the payment.


    Pay by Phone: 

    Contact the Sharecare Forms Department at 866-273-4039. We like to make it as easy and convenient as possible for you. We accept all major credit cards. We do not accept HSA cards as a payment method.

  • What is a Request ID?

    A Request ID is a unique ID specific to the individual patient and form being completed. Sharecare assigns the ID, and if you are unable to locate it, you can contact Sharecare for assistance at 866- 273-4039.

  • Do I need to sign an authorization form even if I want the form sent back to me?

    Yes, we would like all the patients to fill out a Request for Form Completion document when requesting a form to be completed. This document provides the team with information on where and how to send the form. Also, if a disability insurance company calls, we cannot give any information without consent, thus delaying your claim with your disability company. In addition, this document asks for the patient to identify the treating provider, injury/problem date, and last day worked, which will aid in completing your form.

  • I do not use email or know my Request ID number. How can I get status updates on the completion of my form?

    You can contact the Sharecare Forms Department at 866-273-4039 for the status of your form, as well as the Request ID number associated with your form.

  • I need to update the information on my FMLA or Disability paperwork. What do I need to do?

    We understand that FMLA forms, as well as disability determinations, may require an update of your medical information from your recent doctors' visit. You will need to re-submit the new paperwork to Manchester OB/GYN Associates for Sharecare to complete in such cases. There will be a fee of $35.00 required for any updates requested.

  • When will I receive my completed forms?

    Please allow 48 hours for Sharecare to receive your form from the time you submit it to Manchester OB/GYN Associates. Once payment is received, it may take up to 5-7 business days to complete the forms. It is imperative to submit  all information and make the pre- payment as soon as possible; failure to do so will delay the process.

  • I submitted my paperwork but no longer need it to be completed. How can I cancel it?

    You can contact the Sharecare Forms Department at 866-273-4039 for assistance.

  • I still have questions?

    Please reach out to our team at Sharecare, and we are happy to discuss any questions you might have. Contact us at 866-273-4039.

  • When will I receive my completed forms?

    Please allow 48 hours for Sharecare to receive your form from the time you submit it to Manchester OB/GYN Associates. Once payment is received, it may take up to 5-7 business days to complete the forms. It is imperative to submit all information and make the pre- payment as soon as possible; failure to do so will delay the process.

Office Policies

Epic Electronic Medical Records

Proud Member of the U.S. Women's Health Alliance

Humana/Tricare

Laboratory Services

We send the majority of blood work and pathology samples to the Elliot Medical Lab (EML). This will generate a separate cytology bill from the lab. A second bill from Pathology Specialists of NH will also occur for all pathology samples. If you would like to have your labs and pathology go to an independent laboratory please notify your medical assistant the day of your visit. If you do not inform the staff of which lab to use the day of your service it will be sent to Elliot Medical Lab automatically. Any questions please contact your health insurance directly prior to your visit. 
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