Virginia Counseling Associates

Forms 

If you are new to Virginia Counseling Associates, please complete the forms listed below and bring them your first appointment.

 

• Outpatient Intake Form

 

• Notice of Privacy Practices Acknowledgement

 

   Click here to read our Notice of Privacy Practices

 

• Insurance Release and Financial Policy

 

• Missed  Appointments Policy

 

In the event that we need to work with another clinician/provider to coordinate your and your family's care, you will need to authorize us to disclose your information by completing the release form below.

 

• Disclosure Authorization Form