Valley MedPsych
Intake Paperwork
All patients are required to complete the intake paperwork before their appointment can begin. This is usually done upon arrival the day of their appointment. However, if you'd prefer to complete this paperwork prior to arrival, click below to download and print all of the required forms. Please be sure to bring the completed forms with you to your appointment. (You may still have a pre-appointment questionnaire to fill out when you arrive.)
Release of Information
All patients are required to complete the release of information form before their appointment can begin. This is usually done upon arrival the day of their appointment. However, if you'd prefer to complete this paperwork prior to arrival, click below to download and print all of the required form. Please be sure to bring the completed form with you to your appointment.
The release of information form specifies who you consent to receiving your test results/report; we cannot release any information to anyone not listed on this form. Please note, this includes your referring provider and any other providers involved in your medical care.
Privacy Policy
Click below to download our privacy policy.
Referral Form
The referral form is a request for information from the provider regarding the reasons for a patient's referral. Click below to download and print the referral form. The completed form, as well as any additional patient information or records, can be faxed to us at 540-932-8551 or 540-559-6109.