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Current Patient Forms

 

Thank You For Choosing Riverside Counseling Center.

 

 

For Online Documents Below: Click Complete Online

For PDF Documents: Download the pdf version of the form and complete yourself, scan, and submit to frontdesk@riversidecounseling.net

Or fax to: (703) 724-4093

Please only submit paperwork once you have an appointment. Thanks!

Are You A New Patient?

We have bundled all necessary New Patient paperwork below. Complete online, or download a PDF to email.

ADULT New Patient Paperwork
Complete Online
Or Download PDF

MINOR New Patient Paperwork
Complete Online
Or Download PDF

Other Helpful Forms

Telehealth Consent Form   Complete Online / PDF
Release of Information   Complete Online / PDF
Missed Appointment Appeal Form Complete Online  / PDF
Medicare Opt Out Form Complete Online  / PDF

Misc. Doc Attachment Portal Upload Here

For PDFs, please download, complete and email to frontdesk@riversidecounseling.net