Schedule a Visit with Potomac River Clinic

Before an appointment can be made with a clinician, you will need to complete the Potomac River Clinic intake packet. The intake packet contains all the forms that are needed prior to your first appointment. Once you fill out the intake packet for you or your child, please email it to Once the completed intake packet is received, you will be contacted by us.

Please download the appropriate intake packet below, or contact us directly and we can send you the forms. You will need Adobe Acrobat or a similar PDF reader to view these forms on your computer.

Contact us if you have any questions or concerns.

Intake Packets:
Newborn Hearing Screening
Infant ABR

* For your convenience, we bill insurance and accept Medicaid for services.