MyChart Logo MGH
Elliot Health System is a non-profit organization serving your healthcare needs since 1890.
Elliot Memory & Mobility Center

Elliot Memory & Mobility Center

Located within Elliot Behavioral Health Services
445 Cypress Street, Suite 8
Manchester, NH 03103

Phone: 603-552-1670

Hours: Monday thru Friday 8:00 a.m. - 4:30 p.m.

New Patient Information

Patients coming to us for the first time will receive a new patient packet by mail. Occasionally, the packet may be delayed in the mail getting to you in a timely fashion. For your convenience, electronic copies of our previsit questionnaires that can be filled out electronically or printed and brought to your first visit can be found here. It is not necessary to fill out both questionnaires. Most patients will receive the Medical/Mobility Questionnaire. Those patients only seeing Dr. Gourvitz for neuropsychological assessment will fill out the neuropsychological questionnaire.

Pre-visit Medical/Mobility Questionnaire

Pre-visit Neuropsychological Questionnaire

Patient Feedback Form

We grow by learning not only what we’re doing right but also by what we could be doing better. Please let us know about your visits with us so that we can continue to improve our services. Forms can be emailed to , sent by mail or drop it off in our feedback box at the front desk.

Advance Care Planning Guide - This downloadable booklet offers information about the importance of completing Advance Directives including the Durable Power of Attorney for Healthcare and Living Will documents. The booklet contains a standard form that can be filled out and is valid in the state of New Hampshire when notarized. Notary services are available for our patients here at EMMC.

For more information on the Elliot Memory & Mobility Center please call 603-552-1670.