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Please print the appropriate form(s). Bring your completed form(s) to your next appointment. Thank you.

Medical History Form

Emergency Information Form

Child and Adolescent History Form

Release of Information

Requires Adobe Acrobat Reader

Virginia Department of Behavioral Health and Developmental Services
Resources for Civil Commitment Law Changes (effective July 1, 2014)

Virginia Community Services Boards
Alexandria CSB
Arlington County CSB
Blue Ridge Behavioral Healthcare
Central Virginia CSB
Chesapeake CSB
Chesterfield CSB
Colonial CSB
Crossroads CSB
Cumberland Mountain CSB
Danville-Pittsylvania CSB
Dickenson County Behavioral Healthcare
District 19 CSB
Eastern Shore CSB
Fairfax Falls Church CSB
Goochland-Powhatan CS
Hampton-Newport News CSB
Hanover CSB
Harrisonburg-Rockingham CSB
Henrico Area Mental Health and Retardation Services
Loudoun County CSB
Middle Peninsula-Northern Neck CSB
Mount Rogers CSB
New River Valley CSB
Norfolk CSB
Northwestern CSB
Piedmont CSB
City of Portsmouth Dept. of Behavioral Healthcare Services
Prince William County CSB
Region Ten CSB
Richmond Behavioral Health Authority
Rockbridge Area CSB
Southside CSB
Virginia Beach Human Services
Western Tidewater CSB
Virginia Association of Community Services Boards

Planning District 16 Government Sites
City of Fredericksburg
Stafford County
Spotsylvania County
Caroline County
King George County

Intellectual Disability Information
National ARC
The ARC of Virginia

Mental Health Information
Mental Health America
Mental Health America of Fredericksburg

National Alliance on Mental Illness
National Alliance on Mental Illness - Virginia
National Alliance on Mental Illness - Rappahannock
Virginia Psychiatric Rehabilitation Association (VAPRA)
Recovery in Motion Peer Center

Area Mental Health Providers
Fredericksburg Counseling Services
Snowden at Fredericksburg
Spotsylvania Regional Medical Center

Substance Abuse Information
Substance Abuse & Mental Health Services Administration

Addiction Center
Addiction Resource
Drug Rehab

Resource Information
Virginia Family Special Education Connection
Quitday - Helps You Quit Smoking for Good
American Lung Association
Cerebral Palsy Guidance

RACSB is not responsible for the content on the linked pages.






Rappahannock Area Community Service Board  |  600 Jackson Street  |  Fredericksburg, VA 22401  |  (540) 373-3223