Elliot Health System is a non-profit organization serving your healthcare needs since 1890.

Developmental and Behavioral Pediatrics

275 Mammoth Road, Suite 1
Manchester, NH 03109

Phone: 603-663-3222
Fax: 603-663-3229

Hours: Monday-Friday, 8:00 a.m. - 5:00 p.m.

New Patient Packets for Parents and Guardians

If you have been referred to Elliot Developmental-Behavioral Pediatrics, click the link below to download and print the New Patient Parent/ Guardian Questionnaire, to complete and mail or fax to us. Also download and print the appropriate form for your child’s age to have School, Early Supports and Services, or other Therapy service complete and fax or mail to us.

New Patient Parent/Guardian Questionnaire

Age Zero to Five years Early Support, Therapist or School Questionnaire

Age Five and Over School Questionnaire

Click this link to download and print Release of information form

Please complete one for each service provider your child has used (early supports and services, therapy services such as speech or OT, school, mental health, medical specialists, etc.) Sign and fax or mail the release to us. Ask each provider to send us any reports of evaluations.
Fax: 603-663-3229
Elliot Developmental and Behavioral Pediatrics
275 Mammoth Road, Suite 1, Manchester, NH 03109