Forms

Primary Care

Annual Physical / Wellness Exam
Sick Visit
Behavioral Health
Weight Loss Management
Chronic Illness Management

$Insurance

Medical Marijuana Card

NYS Only Certification
3/6/12 Month Certification
$75.00 without us obtaining records
$99.00 with us obtaining records
$145.00 per yearly certification

$

Substance Abuse Treatment

1:1 Counseling
Medically Supervised
Holistic Approach
Self-Paced Program
Unique Treatment Plan

$Varies

 

 Medical Release Forms

For when you need to give Cross Valley Health & Medicine permission to release your medical information on your behalf, please click on the following links below to access the electronic portal that pertains to you in your preferred language.

HIPAA Release > (En Español)

Behavioral Health Services of the Hudson Valley Release of Medical Information > (En Español)