• Email
    • Facebook

  • Request an Appointment Contact Us

    4337 Cox Road Glen Allen, VA 23060
    tandemmentalhealth@gmail.com
    Phone: 804-277-9877 | Fax: 804-270-1211

    • Home
    • About Us
      • Our Practice
      • Dr. Robyn Nunley, Co-Owner, Ph.D., LPC, LMFT
      • Dr. Ariel Ham, Co-Owner, Psy.D., LCP, CSOTP, CATP
      • Dr. Juliet Cameron, Psy.D, LCP, ADHD-CCSP, CATP
      • David Sorrentino, M.A., LPC, CSOTP
      • Amber Golden, M.S., LPC, ATR
      • Dr. Amanda Campbell, Ph.D., LCP
      • Rachel Boykin, MS, LPC
      • Rhiannon Alley, M.Ed., LPC, CSOTP, CGIP
      • Mckayla Parker, M.S., Resident in Counseling
      • Avery Craddock, Mental Health Counseling Intern
      • Shelby Andreasen, M.S., Clinical Psychology Intern
    • Services
      • Individual Therapy
      • Group Therapy
      • Family Therapy
      • Couples Therapy
      • Art Therapy
      • Psychological & Educational Assessments
      • The Snoezelen Room
      • Workshops & Trainings
    • Getting Started
      • Therapy FAQ’s
      • Request an Appointment
      • Client Forms
      • Request your Superbill
      • Managing Treatment Cost
      • Virtual Session FAQ’s
    • Careers
    • Contact Us
    • GFE’s

    Client Forms

    The following forms are here to help you get started. Please download and look them over, so that your first appointment will be productive.

    Contact Information Form

    Release of Information Form

    Notice of Privacy Practices (HIPAA)

    Telepsych Confidentiality and Consent

     

     

  • Contact Us

      By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

    Office Hours
    Tuesday: 9:00am – 7:00pm
    Wednesday: 9:00am – 7:00pm
    Thursday: 9:00am – 7:00pm
    Friday: 9:00am – 5:00pm
    Saturday, Sunday, Monday: CLOSED (appointments available as needed)
    APA
    AAMFT
    AAMFT

  • Tandem Mental Health Associates, Inc. |   804-277-9877

    A Website by Brighter Vision