CONTACT, DIRECTIONS, FORMS


CONTACT

Elise M. Bon-Rudin, Ed. D.
(603) 672-0777
82A Ponemah Road, Amherst, NH 03031
elise_bon-rudin@earthlink.net

Appointments week days, early evenings

DIRECTIONS
My office is half-way between 2 large shopping plazas on 101A in Amherst and Milford, 0.2 miles north of the intersection of 101A West and Route 122 North (Ponemah Road), in the direction heading towards the Village of Amherst.

My practice is located in a small, private building in Amherst, NH, 0.2 miles from the juncture of Routes 101A and 122, between Amherst and Milford.

It is easily accessed from Route 3 and NH Routes 101, 101A and 13.

My office is next to the Amherst golf course.
Look for the sign for Currier Lumber.
Our building shares the driveway with Currier Lumber.
There is ample free parking.


- From Route 3 and points east and north
Take Exit 8, towards Amherst & Milford. The long exit will place you on Route 101A West. Drive west several miles until you see the Wal-Mart on your left. Continue 1.5 miles or approximately 3 minutes from the Wal-Mart. Turn right at the railroad crossing sign, onto Route 122 N. (Ponemah Road) towards Amherst. Continue 0.2 miles. At the sign for Currier Lumber, turn right into the driveway.

- From Route 3 and points south
After crossing into New Hampshire, take Exit 8.  Follow directions above.

- From Milford

A short distance after Route 101, turn left onto Route 122 N. (Ponemah Road), at the sign for the railroad crossing. Continue as above.

- From Route 101 and other points west
Take the Nashua exit. Turn right onto 101A East. Take the first left onto Route 122 N (Ponemah Road) at the sign for the railroad crossing. Continue as above.

- From Hollis, Brookline, and other points south
Take Silver Lake Road (Route 122 North). Cross 101A West onto Ponemah Road. Continue as above.

Please feel free to contact me:

- to schedule an initial consultation session 
- to discuss if therapy might be helpful for you
- to discuss ideas for a presentation to your professional or community organization.

House calls may be arranged for an additional charge.

Please contact me with any questions or concerns:
by email: elise_bon-rudin@earthlink.net
by phone: 603 672-0777

by mail:   82A Ponemah Road, Amherst, NH 03031


CLIENT FORMS
There are 3 forms needed for us to start working together. The first asks for initial payment information. The second, "Client Agreement," sets out my business policies. The third, "HIPAA," explains your rights and my responsibilities under the Federal Health Information Portability & Accountability Act.

There are 2 ways to access these forms:
1. Click on the link (below) for any document. This will take you to Scribd.com. Type my name in the search bar at the top of the screen.  Download the last 3 documents in the list.
2. Send an email (see above) requesting that the documents be sent to you. If you have questions or concerns about any of the content in these forms, contact me before you sign. If you do not have questions or concerns about these forms, please bring only the single, signed signature page to our first appointment. This is page 7 of the Client Agreement. The other pages are for your records.

Initial Payment Information
https://www.scribd.com/document/331863514/Initial-Payment-Information-0616

Client Information
https://www.scribd.com/document/331636490/Informed-Consent-0316

HIPAA
https://www.scribd.com/document/331636666/HIPAA-092313

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