Intake Department Forms

Syntero Client Rights & Other Notices

For your review only; no need to return.

​

• Dublin Office​

• Lewis Center Office

• Mill Run Office

• Mount Gilead Office

​Mental Health (MH)

• Intake Adult​

• Intake Youth (3-11)

• Intake Youth (12-17)

​

Substance Use Disorder (SUD)

• Intake Adult

• Intake Youth (13-17)​​

​​

Psychiatry Forms

• Intake Form

• Release of Information

• Client Turning 18

• Sliding Fee Application

• Informed Consent for Minors