Bay Rivers Telehealth Alliance serves a 12-county area with a diverse, largely rural population.
- The geographic components of the area are the Northern Neck and the Middle Peninsula, west to Richmond and outreached to the Eastern Shore.
- The counties in the Northern Neck are Lancaster, Richmond, Northumberland, and Westmoreland.
- The counties in the Middle Peninsula are Gloucester, King and Queen, King William, Essex, Mathews, and Middlesex.
- The counties on the Eastern Shore of Virginia are Accomack and Northampton.
- The region is characterized by closely knit communities, surrounded by waterways that border the Chesapeake Bay.