New Patient Forms

Download physician policies and commonly used insurance reimbursement claim forms.

Fairfax Mental Health does not participate with any health insurance policy. Administrative obligations associated with filing insurance claims severely restrict the time available for your care. In most cases, visits are partially or completely reimbursed by your insurance company. In our private practice, less time spent on administrative and billing issues allows more time to be dedicated to your care. Services are tailored to your emotional needs. We are considered out-of-network providers when filing reimbursement claims with your insurance carrier. You will be provided after each visit a fully itemized and coded receipt that can be attached to your insurance reimbursement form.

The providers each have their own policies regarding fees, missed appointments, cancellations due to weather, prescription refills, etc. Please contact them for details about his or her own policies. Downloadable forms are available on each individual physician‘s page.

Physician Forms

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