Gateways Recovery

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Forms

Click to download the following documents: 

Professional Referral Form (PDF)

Patient Referral Form (PDF)

Health Assessment Form (PDF)

Physical Examination Form (PDF)

Legal and Privacy Notice (PDF)

 

Contact Information:  Located at 4760 Madison Road (lower level entrance), Cincinnati, Ohio 45227. 
For more information about Gateways, please call 513.861.0035 or email info@gatewaysrecovery.com

The path to recovery starts with the first step.  Please contact Gateways today.