Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

Note: To download Adobe Acrobat Reader for free, Click here.

CONTACT US

We hope to see you soon

  • Rose Water Psychotherapy, LLC.

    2 Constitution Dr,
    Virginia Beach, VA 23462

    Monday:

    10:00 am - 4:00 pm

    (In-Person / Telehealth Options)

    Tuesday:

    10:00 am - 4:00 pm

    (In-Person / Telehealth Options)

    Wednesday:

    10:00 am - 4:00 pm

    (In-Person / Telehealth Options)

    Thursday:

    10:00 am - 1:00 pm

    (Telehealth Only)

    Friday:

    Closed

    Saturday:

    Closed

    Sunday:

    Closed

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Please do not submit any Protected Health Information (PHI).