Our IntakeQ client portal system requires cookies to be enabled to allow clients to access forms online.

PLEASE NOTE: Ongoing clients and referrals from Madison County Physicians have priority for Attention Assessments.

We have a wait list of @ 2 months for other Attention Assessments. 

To begin the process of becoming a client, 


After you complete and submit the forms, you will be taken to the next step.

After clicking “submit” please wait until directed to another web-page.

Please use the NAME of the Person Who will be the Actual CLIENT!!!

for ADULTS:     Click Here

for a MINOR CHILD** or a Dependent Adult:     Click Here

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

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