Please print and fill out the following forms prior to your appointment.
Authorization for Release of Information
Intake form – 05-2017
HIPAA pamphlet
HHS History Form
HHS – HIPAA Form
Please print and fill out the following forms prior to your appointment.
Authorization for Release of Information
Intake form – 05-2017
HIPAA pamphlet
HHS History Form
HHS – HIPAA Form
6 LOCATIONS TO SERVE YOU!
Columbus, OH - Bethel Road
Columbus, OH - East Broad Street
Grove City, OH
Delaware, OH
Dublin, OH
Westerville, OH