Road to Ready Counseling

Road to Ready CounselingRoad to Ready CounselingRoad to Ready Counseling
  • Home
  • About Us
    • Our Team
    • Blog
    • Contact Us
    • Mechanicsville Office
    • Midlothian Office
    • Join Our Team
    • Resources
  • Services
    • Therapy
    • Adults
    • Children/Teens
    • Immigration Evaluations
    • Professional Development
  • GETTING STARTED
    • New Patient Forms
    • Appointment Request
    • Payment & Insurance
    • Good Faith Estimate
    • Cancellation Policy
  • Referral Form
  • Patient Portal
  • More
    • Home
    • About Us
      • Our Team
      • Blog
      • Contact Us
      • Mechanicsville Office
      • Midlothian Office
      • Join Our Team
      • Resources
    • Services
      • Therapy
      • Adults
      • Children/Teens
      • Immigration Evaluations
      • Professional Development
    • GETTING STARTED
      • New Patient Forms
      • Appointment Request
      • Payment & Insurance
      • Good Faith Estimate
      • Cancellation Policy
    • Referral Form
    • Patient Portal

Road to Ready Counseling

Road to Ready CounselingRoad to Ready CounselingRoad to Ready Counseling
  • Home
  • About Us
    • Our Team
    • Blog
    • Contact Us
    • Mechanicsville Office
    • Midlothian Office
    • Join Our Team
    • Resources
  • Services
    • Therapy
    • Adults
    • Children/Teens
    • Immigration Evaluations
    • Professional Development
  • GETTING STARTED
    • New Patient Forms
    • Appointment Request
    • Payment & Insurance
    • Good Faith Estimate
    • Cancellation Policy
  • Referral Form
  • Patient Portal

Your First appointment

Please complete new patient forms provided below within 24 hours of requesting a new patient appointment. It is required to complete a credit card form if you have a commercial (private insurance) OR if you are self-pay to be sent directly to you from our EHR system (SimplePractice/Client Portal Road to Ready Counseling). If you need of assistance completing the forms below, please contact us at admin@roadtoreadycounseling.com

Completing the intake forms:

There are two options for completing the intake forms for new patients: 

1- You can email the forms provided below along with a copy of the FRONT and BACK of your insurance card(s) to admin@roadtoreadycounseling.com within 24 hours of scheduling your first appointment. If you have a commercial (private) insurance or are self-pay, you will also be required to complete a credit card form to be sent directly to you from our EHR System (SimplePractice/Client portal Road to Ready Counseling).

2- You can request for intake forms to be emailed directly to you from our EHR system (SimplePractice/Client portal Road to Ready Counseling) by sending an email to admin@roadtoreadycounseling.com with the following information: patient's first name, patient's last name, parent/legal guardian name (f the patient is a minor), and phone number. 


New Patient Forms

Please complete the following 7 intake forms that are required for new patients within 24 hours of scheduling your first appointment. 

Email the completed forms and a copy of the Front and Back of your Insurance Cards to admin@roadtoreadycounseling.com


Please complete the Standard Intake Questionnaire that represents the patient (Adults OR Children): Only One standard questionnaire is required.  

Standard Intake Questionnaire for Adults (pdf)

Download

Standard Intake Questionnaire for Children (pdf)

Download

The following 6 forms are required for ALL new patients:

Demographics form (pdf)

Download

Consent for Telehealth Consultation (pdf)

Download

Financial Policies (pdf)

Download

Informed Consent for Psychotherapy (pdf)

Download

Notice of Privacy Practices (pdf)

Download

Practice Policies (pdf)

Download

Road to Ready Counseling, LLC

Road to Ready Counseling, LLC Locations: 


 Mechanicsville VA Office: 7465 Old Hickory DR, Suite D, Mechanicsville, VA 23111.   


Midlothian VA Office: 1519 Huguenot Road Suite 200, Midlothian, Virginia 23113.


 Phone Number: 804-404-8222 


Email: admin@roadtoreadycounseling.com


Copyright © 2022 Road to Ready Counseling, LLC - All Rights Reserved.

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