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(304) 232-7232
Behavioral Health Counseling
New Patient Fomrs
Child & Adolescent Registration Form
Adult Registration Form
Other Fomrs
Authorization for Release of
Health Records
Please select the appropriate form to
download and complete as much information as possible. You can bring the forms with you to the appointment,
email them to
bhcwv@outlook.com
,
or mail* them to us at
1025 Main Street, Suite 310
Wheeling, WV 26003
*if mailing, please get them in the mail at least 5 business days prior to your appointment to ensure we receive them.