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Dr. Clarizio
Dr. Clarizio
  • Our Practice
    • About Dr. Clarizio
    • Testimonials
    • Our Blog
  • Procedures Offered
    • Tooth Extractions
    • Wisdom Teeth Extractions
    • Dental Implants
    • Information About Oral Diseases
  • Patient Information
    • Scheduling Your Appointment
    • Insurance Information & Financial Policies
    • Billing & Payments
    • Patient Forms
    • Your First Office Visit
    • Pre-Op Instructions
    • Post-Op Instructions
    • Emergency Care
    • Additional Resources
  • Information for Doctors
    • Send Referrals
    • Dental Resources
  • FAQs
  • Contact Us
    • Billing Department
  • 603-436-8222
  • Get Directions
  • Pay My Bill
  • Our Practice
    • About Dr. Clarizio
    • Testimonials
    • Our Blog
  • Procedures Offered
    • Tooth Extractions
    • Wisdom Teeth Extractions
    • Dental Implants
    • Information About Oral Diseases
  • Patient Information
    • Scheduling Your Appointment
    • Insurance Information & Financial Policies
    • Billing & Payments
    • Patient Forms
    • Your First Office Visit
    • Pre-Op Instructions
    • Post-Op Instructions
    • Emergency Care
    • Additional Resources
  • Information for Doctors
    • Send Referrals
    • Dental Resources
  • FAQs
  • Contact Us
    • Billing Department
  • 603-436-8222
  • Get Directions
  • Pay My Bill
surgical nurse
  • Scheduling Your Appointment
  • Insurance Info. & Financial Policies
  • Billing & Payments
  • Patient Forms
  • Your First Office Visit
  • Pre-Op Instructions
  • Post-Op Instructions
  • Emergency Care
  • Additional Resources

Patient Forms

The following patient forms are available for your convenience.

Patient Information Form

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Medical Info Release Auth.

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Patient Insurance Verification

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Notice of Privacy Practices

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  • Patient Information
  • Scheduling Your Appointment
  • Insurance Info. & Financial Policies
  • Billing & Payments
  • Patient Forms
  • Your First Office Visit
  • Pre-Op Instructions
  • Post-Op Instructions
  • Emergency Care
  • Additional Resources

Office Hours:

Portsmouth Office

Open Mondays, Tuesdays and Fridays

8:00am - 5:00pm

603-436-8222

Somersworth Office

Open Thursdays

8:00am - 5:00pm

603-436-8222

louis clarizio logo

Portsmouth Office

566 Inslington Street
Portsmouth, NH 03801

Tel: 603-436-8222
Fax: 603-433-3299
Open: Mon, Tues, and Fri
Hours: 8:00am to 5:00pm

Somersworth Office

504 High Street
Somersworth, NH 03878

Tel: 603-436-8222
Fax: 603-749-1707
Open: Thurs
Hours: 8:00am to 5:00pm

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Do You Have a Referral?

We request patients be referred to our practice by their general dentist.

I have a referral, call: 603-436-8222

I am a referring doctor, call: 603-436-8222

I do NOT have a referral: Find a Dentist.