(540) 293-9788 5215 Starkey Road, SW Roanoke, VA 24018 angiemitchell@cftherapy.org

Intake Paper-work

After scheduling your appointment you can download and print the intake paper-work.  Fill it out and bring it with you to your first appointment.  Thank you.

Child Intake Paperwork

Adult Intake Paperwork


In order for us to service your account or to collect any amounts you may owe us, you authorize us and our affiliated clinicians, as well as their affiliates which include debt collectors, to contact you at any telephone number associated with your account, including wireless telephone numbers, which could result in charges to you. Methods of contact include but are not limited to the use of pre-recorded voicemail messages, artificial voicemail messages, automatic telephone dialing systems, predictive telephone dialing systems, automated SMS text message reminders, and facsimile as applicable.


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