Virginia Family Services Payment Form

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                  Outpatient Therapy (Self Pay)

                  Individuals who would like to self-pay for Outpatient Therapy (1-Hour Session). 

                  $130.00
                    
                  Mental Health Assessment

                  For Individuals who would like to self-pay for Mental Health Assessment. 

                  $175.00
                    
                  VASAP Assessment

                  Call and register for VASAP classes BEFORE paying any VASAP fees.  Call: 804-313-6767

                  $175.00
                    
                  VASAP Class

                  Each class costs $65 per participant.  Ensure you are registered for VASAP classes BEFORE paying. Call: 804-313-6767, if needed 

                  $65.00
                    
                  Drug Test

                  Drug Test are REQUIRED component of VASAP classes. 

                  $20.00
                    
                  Medical Records- 20 pages or less

                  Medical records 20 pages or less

                  $23.00
                    
                  Medical Records- 21-60 Pages

                  Medical records 21-60 pages. If more than 60 pages are needed, please call for further assistance. 804-313-6767 EXT 509

                  $46.00
                    
                  Total
                  $0.00

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