Thank you for choosing Child & Family Counseling Group. To help navigate your first visit to our practice, please read the information below. Please feel free to contact our office if you have any questions.
10521 Rosehaven Street, Suite 100 Fairfax, VA 22030
- Please see patient forms below to prepare for your first visit or update information
- You may scroll to the bottom of this page for our "Q & A"
- If you have an appointment before 7 a.m., after 6 p.m or on weekends please contact our office for the building access code
- Ample parking is available in the back of our building
- New patient appointments require 48 hours’ notice of cancellation & existing patients require 24 hours’ notice of cancellation to avoid a fee
- Our front office telephones are answered Monday-Friday from 9 a.m.- 5 p.m. (12 p.m.- 1 p.m. phones are briefly turned off during the lunch hour)
- You may email us with any questions or concerns at: [email protected]
- Please scroll to the bottom of our home page for directions
You may access our New Patient Intake Packets here:
Adult Patient Packet (18 +) [ PDF ]
Child Patient Packet (17 and under) [ PDF ]
Individual Practice Forms:
- Credit Card Authorization Form [ PDF ]
- Authorization for Release of Information [ PDF ]
- Acknowledgement Receipt for Notice of Privacy Practices [ PDF ]
- Electronic Communication & Consent Release [ PDF ]
- Internal Release of Information [ PDF ]
- Patient History Form (Adult) [ PDF ]
- Patient History Form (Child and Adolescent) [ PDF ]
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.