Intake Forms

At your first appointment, please bring the following:

-ID card
-Health Insurance card (We accept most Anthem, Cigna and Aetna plans)
-Prior Mental Health/Primary Care medical records (including blood test results)

Please note, Virginia Integrative Psychiatry does not participate with Medicare or Medicaid plans

Virginia Integrative Psychiatry is NOT an emergency mental health facility.  If you are in crisis, please call 911 or go to the nearest emergency room.

Please download, fill out and print all applicable forms. This will save time upon arrival to your appointment.

Patient Intake Questionaire
Prior Authorization Policy
Office Policies
Policy on Medical Records and Completion of Forms
Policy on Consultation in Legal Matters
Informed Consent for Treatment
Notice of Privacy Practices
Financial Statement
Buprenorphine – Informed Consent (Only complete if applicable)