Cancer Care

 

 

Forms

Contact Us
  • Lebanon, NH (DHMC)
    Phone: (603) 653-3541
    Phone 2: (800) 251-0097
    Fax: (603) 653-3583
    Email Us
  • Manchester, NH
    Phone: (603) 629-1828
  • Nashua, NH
    Phone: (603) 577-4170
    Fax: (603) 577-4169
  • St. Johnsbury, VT
    Phone: (802) 473-4100
  • Cancer Help Line
    Toll-Free
    Phone: (800) 639-6918

Use the following forms to help you work with the Familial Cancer Program. These forms are provided in PDF format (Adobe Reader required).

Medical records request forms: