Atlantic Cardiology Associates - Portsmouth, New Hampshire - We are dedicated to providing the best cardiovascular care available.
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  • ICANL Accreditation
    Atlantic Cardiology Associates nuclear lab is reaccredited
    learn more
  • Dr. Mark Jacobs
    Board Certified in Nuclear Cardiology
    read article
  • ePrescribe
    is a new convenience at Atlantic Cardiology
  • Dr. Mark Jacobs
    travels to Bolivia to provide cardiac services.
    learn more
  • Electrophysiology also now available at ACA thanks to Drs. Hook & Martin.
    learn more

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Forms

In order to make your visit with us more convenient, we have included some important forms for you to complete.


Please print this form and complete it at your convenience. Bring it with you when you come for your appointment.


Administrative

· Patient Registration Form
· Medical Record Release
· Authorization for Disclosure of Protected Health Information (PHI)


Test Instructions

· Nuclear Stress Test
· Carotid Ultrasound
· Echocardiography
· Stress Echocardiography
· Nuclear Stress Testing


Adobe Acrobat You must have Acrobat Reader in order to access our forms.
We provide a free download of Adobe Acrobat Reader
for your convenience.
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