Answers to common questions

NH Psychiatry accepts new patients as appointment availability allows. Availability may vary based on age, services requested, scheduling availability, insurance participation, and whether the requested care is within the scope of the practice.

New patients may request an appointment through the online booking portal. After the request is submitted, the office reviews the information provided and follows up with next steps.

No. An appointment request is the first step in the new-patient process. Requests are reviewed based on the service requested, practice scope, appointment availability, and the information provided.

The office reviews the request for clinical fit, scheduling availability, and insurance or payment information. If the appointment is appropriate, you will receive instructions to complete intake paperwork before the visit.

The first visit is a comprehensive psychiatric evaluation and treatment-planning appointment. The provider reviews current concerns, symptoms, psychiatric history, medical history, prior medication trials, family history, relevant social history, treatment goals, and safety concerns. The goal is to understand what is happening and develop a practical treatment plan.

Complete all requested intake forms before your visit and have an accurate list of your current medications available.

Prior treatment records may be requested when useful for evaluation, medication history, continuity of care, or safe prescribing. If records are requested, the office will let you know what is needed.

NH Psychiatry provides psychiatric evaluation, treatment planning, and ongoing medication management. Appointments may also include psychoeducation, brief supportive interventions, sleep and lifestyle guidance, and practical coping strategies when clinically appropriate as part of medication-management care.

Yes. Medication management is the core service of the practice. Treatment may include starting, adjusting, continuing, or discontinuing psychiatric medications when clinically appropriate.

NH Psychiatry does not provide standalone weekly psychotherapy. Brief supportive, educational, or skills-based interventions may be included as part of medication management when clinically appropriate. Patients who need ongoing therapy may be referred to a therapist.

NH Psychiatry is primarily designed for patients seeking ongoing psychiatric medication management. An evaluation is part of establishing care, but the practice is not primarily intended for one-time legal, forensic, custody, disability, or court-related evaluations.

Common concerns may include ADHD, anxiety disorders, depression, mood disorders, bipolar-spectrum disorders, OCD, PTSD or trauma-related symptoms, sleep-related concerns, irritability, emotional dysregulation, and other psychiatric concerns appropriate for outpatient medication management.

Yes. NH Psychiatry offers Spravato® / esketamine treatment for eligible adults with treatment-resistant depression. Spravato treatment requires clinical screening, insurance review or authorization when applicable, required safety procedures, transportation planning, and in-office monitoring after each treatment session. NH Psychiatry does not currently offer TMS or IV ketamine treatment.

No. NH Psychiatry does not provide full neuropsychological or psychoeducational testing. If formal testing is needed for learning disorders, cognitive concerns, complex diagnostic clarification, school documentation, or accommodations, referral to a psychologist or neuropsychologist may be recommended.

No. NH Psychiatry does not provide custody evaluations, forensic evaluations, court testimony, legal opinions, or treatment primarily intended for litigation.

Substance-use concerns may be addressed when they can be safely managed within an outpatient psychiatric setting.

Patients who require detoxification, intensive addiction treatment, medication-assisted addiction treatment not offered by the practice, or a higher level of substance-use care may be referred to an appropriate specialty program.

Yes. ADHD can be evaluated and treated when clinically appropriate. ADHD care may include clinical interview, rating scales, review of childhood and current symptoms, assessment of functional impairment, medical and psychiatric history, and review of prior records when available.

Stimulants may be prescribed when clinically appropriate and when the diagnosis, safety profile, monitoring plan, and treatment goals support their use. Stimulants are controlled substances and require regular follow-up, safe use, and adherence to practice policies.

No. Prior stimulant treatment is considered, but continuation is not guaranteed. Medication decisions are based on current symptoms, diagnosis, benefit, side effects, safety, records when needed, and provider judgment.

Follow-up is generally scheduled every 2 to 4 weeks when starting a stimulant or making significant dose changes.

Once treatment is stable, NH Psychiatry generally requires monthly follow-up for stimulant treatment, although visit frequency may be adjusted when clinically appropriate.

No. Stimulant prescriptions are not automatic. Schedule II stimulant medications cannot be refilled in the usual sense and require a new prescription when clinically appropriate.

Generally, no. Controlled substances, including stimulants, generally will not be prescribed if the patient is overdue for required follow-up. The provider may require an appointment before sending any additional prescription.

Monitoring may include review of the prescription monitoring program, pharmacy consistency, vital signs, weight and appetite monitoring, rating scales, school or work functioning updates, collateral information when appropriate, urine drug screening, pill counts, or records from prior prescribers.

Lost, stolen, damaged, or misplaced controlled medications are not routinely replaced. Early prescriptions are not guaranteed and may require an appointment and additional clinical or pharmacy review.

Benzodiazepines are generally not first-line treatment for anxiety, insomnia, or long-term symptom management. They may be considered only in limited circumstances after individualized assessment. If used, they are typically short-term, intermittent, and closely monitored.

Follow-up frequency depends on symptoms, medication changes, safety, age, treatment complexity, and medication type. Early in treatment or after medication changes, visits are usually more frequent. Once symptoms and medications are stable, follow-up visits may be spaced out based on clinical need and provider judgment.

When starting a new medication or making a significant medication change, follow-up is commonly scheduled within 2 to 4 weeks to review benefit, side effects, safety, and next steps. Higher-risk situations may require sooner follow-up.

Medication changes generally require an appointment or clinical reassessment so symptoms, response, side effects, safety, and the overall treatment plan can be reviewed.

Messaging is appropriate for communicating concerns or side effects but is not always a substitute for an appointment.

Medication management requires current clinical information. Follow-up visits allow the provider to assess benefit, side effects, safety, ongoing medical necessity, and whether the treatment plan remains appropriate. Missed or overdue visits may delay or prevent medication continuation.

Yes. More frequent appointments may be required for new medications, dose changes, side effects, missed appointments, safety concerns, substance-use concerns, early refill requests, or other clinical concerns.

No. Medication recommendations are based on clinical evaluation, diagnosis, safety, medical appropriateness, previous treatment, and the individual treatment plan. An appointment does not guarantee that a particular medication will be prescribed or continued.

Appointments must be canceled or rescheduled at least 24 business hours before the scheduled appointment time.

For Monday appointments, cancellation must be received by the same appointment time on the prior business day, usually Friday. For example, a Monday 10:00 AM appointment must be canceled by Friday at 10:00 AM.

A late cancellation is an appointment canceled with less than 24 business hours’ notice.

A no-show occurs when a patient does not attend the scheduled appointment and does not cancel within the required timeframe.

Late cancellations and missed appointments may result in a fee. This fee is not billed to insurance and is the patient’s responsibility unless prohibited by law, Medicaid rules, or insurance contract.

Consistent attendance is important for safe and effective psychiatric care.

Patients may be discharged from the practice after any combination of two attendance violations within a 12-month period.

Attendance violations include:

• missed appointments (no-shows)
• late cancellations

A late cancellation is an appointment canceled or rescheduled with less than the required 24 business hours’ notice.

This means that two no-shows, two late cancellations, or one of each may result in discharge from the practice.

Missed or late-canceled appointments may also affect medication refills when required follow-up is overdue.

Medication refills, including controlled-substance prescriptions, may be delayed or denied if a patient misses, late-cancels, or is overdue for a required follow-up appointment. For safety reasons, the provider may require an appointment before medication is continued. Bridge prescriptions are not guaranteed.

NH Psychiatry accepts many major commercial insurance plans and New Hampshire Medicaid. Coverage varies by plan, network, employer group, behavioral health benefits, deductible, copay, referral requirements, and authorization requirements.

No. NH Psychiatry does not accept Medicare. Patients with Medicare, including Medicare Advantage plans, should contact the office before scheduling if they have questions about whether services can be provided.

Self-pay options may be available for appropriate patients who are not Medicare beneficiaries and who are not using insurance. Self-pay rates are listed on the Insurance & Fees page.

Yes. Patients are responsible for any copays, deductibles, coinsurance, non-covered services, or balances assigned by their insurance plan.

Insurance generally does not pay for missed appointments, late cancellations, form completion, record preparation, or other non-covered administrative services. These fees are usually the patient’s responsibility unless prohibited by law or insurance contract.

Yes. In-person appointments are available at the office in Alton, NH when clinically appropriate or required.

Initial evaluations are generally completed in person unless otherwise approved by the provider. In-person visits may also be required when clinically appropriate or necessary for medication monitoring, safety, or applicable prescribing requirements.

Yes. NH Psychiatry offers virtual appointments when clinically appropriate and when the patient is physically located in a state where the provider is licensed and legally able to provide care.

Usually no, unless the provider is licensed and legally permitted to provide care in that state. Patients must disclose their physical location at the start of each telehealth visit.

No. For safety and privacy reasons, telehealth appointments should not be attended while driving.

You need a private location, reliable internet connection, and a device with a camera and microphone. Patients should not attend telehealth visits from public spaces or locations where privacy cannot be maintained.

Patients should use the approved patient communication system for non-urgent questions, refill requests, forms, and scheduling needs. Messages should not be used for emergencies.

No. Patient messages are not monitored 24/7 and should not be used for emergencies, urgent safety concerns, or crisis situations.

Request routine refills through the practice’s approved patient communication system before you run out of medication.

Please allow several business days for routine requests. A refill may require clinical review or an appointment depending on the medication, required monitoring, and timing of the most recent visit.

Patients should request refills directly through the practice’s approved process rather than relying on pharmacy-generated requests. This helps ensure that the correct medication, dose, pharmacy, and clinical information are reviewed.

After-hours refills are not routine and should not be expected. Patients are responsible for requesting refills during business hours and attending required appointments.

Forms may be completed only when clinically appropriate and usually only for established patients after sufficient evaluation and treatment history. Form completion may require a separate fee and additional time.

Possibly. Accommodation letters are considered only when clinically appropriate and supported by evaluation, history, functional impairment, and the treatment relationship.

Disability paperwork may require detailed functional assessment and treatment history. NH Psychiatry is not primarily a disability-evaluation service.

FMLA paperwork may be considered for established patients when clinically appropriate and supported by diagnosis, functional impact, and treatment history. Additional fees and time may apply.

Forms and letters are not completed during routine appointment time unless arranged in advance. Turnaround time varies by complexity and schedule.

NH Psychiatry does not provide 24/7 crisis services. If you are in immediate danger, call 911 or go to the nearest emergency department. You may also call or text 988 for crisis support. New Hampshire Rapid Response is available at 833-710-6477.

If outpatient medication management is not sufficient, the provider may recommend a higher level of care such as emergency evaluation, intensive outpatient treatment, partial hospitalization, inpatient treatment, substance-use treatment, or another specialty service.