DR. JOHN LYNCH
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Forms

The following forms may be printed, filled out and brought to your appointment.

  • Cancellation and No-Show Policy
  • Confidential Intake Form for Adults
  • Notice of Privacy Practices
  • Psychologist-Patient Services Agreement​
  • Patient Telehealth Informed Consent


​© John Lynch, Ph.D
Summit Emotional Health 
8921 Three Chopt Road
Richmond, Virginia 23229
​804-562-6557
​John.Lynch@summit-eh.com

​In case of an emergency, please dial 911.
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  • Home
  • About
  • Services
  • Forms
  • Books
  • Contact