Behavioral Health and Wellness Associates of Northern Virginia

Behavioral Health and Wellness Associates of Northern Virginia

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Home
About Us
Services
Fees
Contact Us
Forms

Required New Patient Forms

ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES (docx)

FINANCIAL POLICY (docx)

NOTICE OF PRIVACY PRACTICES (docx)

PCP RELEASE (docx)

Therapy Policies (docx)

ADULT_BACKGROUND_INFORMATION_FORM (docx)

CHILD BACKGROUND INFORMATION FORM (docx)

CHILD NEW PATIENT REG FORM 2 (docx)

Psychological Evaluation Policies (docx)

Therapy Policies (docx)

Optional / Supplemental Forms

CREDIT CARD AUTHORIZATION FORM (docx)

OPTIONAL AUTH TO RELEASE TREATMENT RECORDS (docx)

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