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Getting Started

To get started with us, click to open one of the following forms. The initial intake form is intended for potential patients over age 15 and the child intake form is for those under14. Once the form has been filled out, please email, mail or fax the completed form to [email protected] with a copy of your photo ID and insurance card.   

**Please call the office prior to submitting paperwork to check our availability.**

Our business office is open from 8:30am to 4:30pm Monday through Thursday. After hours available by appointment only.

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Fax: 540-433-3805

Office phone: 540-434-8450

FLRCCounseling

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