New patient information & patient forms

New patient information

We welcome new patients at UVA  Behavioral Health Manassas. We serve adult patients as well as pediatric patients ages three and older.

If you or a loved one are experiencing a psychiatric emergency, or threatening the safety of yourself, themselves or others, go to the nearest emergency room or call 911.

Arrive at least 15 minutes before your first appointment. Bring with you:

• A photo ID.
• Your insurance card or the insurance card covering your child if your child is the patient.
• Your method of copayment or payment in full. Click here for insurance and billing information.
• Any medications you are currently taking including over-the-counter medications, vitamins and supplements.

Patient forms

We need to collect some important information before your visit or the visit of your child. Select any of the links below to download important forms. If you do not complete these forms ahead of time, they will be available for you in our office:

• Communicating Your Health Information
• Admission Face Sheet
• Child/Adolescent Development and Medical History Parent/Guardian Form
• Confidential Health History Questionnaire
• Consent for Minor with Custody Verification
• Authorization to Release Health Information