Eden Counseling & Consulting

Serving all Virginians with In-Person and Telehealth Services
Established in 1995

Contact Us

6330 Newtown Road
Suite 300
Norfolk, VA 23502
757.466.3336

Have A Question Or Want To Make An Appointment? Call 757-466-3336

Genesis Counseling Logo

Eden Counseling Is Now Part Of Genesis Counseling Center. Serving Our Community With Excellence Together.
Learn More About Genesis HERE

Patient Forms

We offer forms on our website for your convenience.
All forms can be printed, completed and brought to your first visit.

Adult Patient Forms (18 yrs & above) are also offered in a Fillable format, and can be completed online, printed and brought to your first visit.

Adult Patient Forms (18 yrs & above)
DOWNLOAD FORMS & COMPLETE

Please download all applicable forms, fill them out, print and bring them to your first session

Child Patient Forms (Below 18 Years of Age)
DOWNLOAD FORMS & COMPLETE

  • Professional Services Agreement

    DOWNLOAD

  • Patient Information & Social History (Child/Adolescent)

    DOWNLOAD

  • General Release of Information

    DOWNLOAD

  • Primary Care Physician (Release of Information)

    DOWNLOAD

Adult Patient Forms (18 yrs & above)
FILLABLE FORMS

Please fill out all of these forms online, print them and bring them to your first session

  • Professional Services Agreement- Fillable Form

    DOWNLOAD

  • Patient History (Adult)- Fillable Form

    DOWNLOAD

  • General Release of Information- Fillable Form

    DOWNLOAD
    • Anthem Health Insurance
    • Aetna Health Insurance
    • Cigna Health Insurance
    • DMAS Health Insurance
    • Humana Health Insurance
    • Medicaid Health Insurance
    • Medicare Health Insurance
    • Molina Health Insurance
    • Optima Health Insurance
    • TriCare Health Insurance
    • UHC Health Insurance
    • Virginia Premier Health Insurance

Location

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