Richmond Clinic location:
Intake Form - Richmond Clinic
Please complete the following intake form to initiate a referral and/or to join our wait list. Upon receipt, one of our clinic coordinators will contact you to discuss next steps. Please note that there is a waitlist for all assessments and availability is limited at this time in our Richmond location
* Please note, we cannot guarantee the confidentiality of information transmitted through e-mail including the intake form. Please be aware of this limitation when contacting us.