Online Outpatient Intake Form

We appreciate your interest in our Outpatient professional services at the Lindner Center of Hope. Please take a few minutes to tell us about yourself or your child.

If you prefer to complete our intake process by talking to a member of our staff, please call 513-536-0570.  Our intake staff work Monday – Friday, 8am – 5 pm (excluding holidays).  If the line is busy when you call, please leave a message on the answering machine.

Your wellbeing and safety are important to us.   If you are experiencing an emergency, dial 911 or go to the nearest emergency room.  Or Dial 988 to reach the Suicide and Crisis Lifeline.

Please note:  We will not assign a provider to care for you based on a computer program.  The information we collect from you is important and we use it to find the best available provider at the Lindner Center of Hope to meet your needs.

Because of this individualized intake process, our process may take a few days.   If you do not back to us within two business days, please phone us at 513 536-0570.

Mail, fax, and email options

If you are not submitting the completed forms online, you may return them by mail, fax or email.

Mail to:
Lindner Center of HOPE Registration
4075 Old Western Row Rd.
Mason, OH 45040

Fax-to-Email line: 513-536-0648
Email: [email protected]

For further assistance, you can reach us at one of the numbers below.

Lobby Registration Direct Line: 513-536-0560