You can begin the process of accessing treatment by registering for our paperwork portal and completing the appropriate form below :

 

REGISTER FOR OUR PAPERWORK PORTAL (intakeQ)*: Click here

*make sure you remember the password you create!

and

COMPLETE THE INITIAL PAPERWORK BELOW:

 

ADULTS:

Adult Client Intake Questionnaire :  Click Here

 

MINOR CHILD** or Dependent Adult: 

PLEASE USE THE CLIENT NAME TO CREATE THE ACCOUNT!!!

Dependent Client Intake Questionnaire Click Here

**PLEASE NOTE: We must have copies of ALL custody paperwork BEFORE we can schedule a minor child for treatment

 

After you have registered for the portal and completed the initial paperwork, we will check your insurance coverage and send you additional forms to complete. Please monitor your email and intakeQ portal for additional forms and communication.  If you have difficulty completing or understanding the forms, please call 740-845-8652, select the “new client” option and ask for assistance.

 

Other Information:

Review our Privacy Policies Here: Click Here

Review our Complaint Procedures Here: Click Here