Poehailos, Dupont and Associates | Charlottesville mental health

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Main Office
887 B Rio East Court
Charlottesville, VA 22901
Phone: (434) 220-4686
Fax: (434) 220-4687

Satellite Office
199 Spotnap Road, Suite 4
Charlottesville, VA 22911
Phone: (434) 995-5600
Fax: (434) 995-5620

Serving the mental health needs of Virginia's families

Registration Information

Please come 15 minutes early for your first appointment!


New clients will receive registration forms to complete after the initial intake process. View our forms here:

Patient Information


HIPAA and Privacy Practices

Child Patient Registration (ages 2 - 11)

Adolescent Patient Registration (ages 12 - 17)

Adult Patient Registration

Authorization for Release of Information

Consent for Electronic Communications

Informed Consent for Mental Health Treatment by Video Conferencing

Contract for Psychiatric Evaluation