Patient Info

New Patients 

Centerpoint Health is accepting new patients of all ages everyday for all locations.

Please call us at (513) 318-1188 to schedule an appointment today!

Intake Packet

When you arrive for your first appointment at Centerpoint Health, we want to get to know you first. You will be asked to complete several forms prior to being seen by your provider. To get a head start on these forms, please click here to access the Intake Packet. Print, complete, and bring these forms with you 20 minutes before your first appointment. If you would like assistance completing any of this information, our staff will be available to help. 

Patient Forms

Other forms which may be relevant to your care at Centerpoint Health which are made available here for your convenience.

Welcome Letter

Our Welcome Letter gives our new patients a brief overview of our patient-provider relationship. Click here to download the Welcome Letter form. 

Release of Information 

Release of Information (ROI) is a form in which we require all new patients to fill out. This form allows our providers to receive your past medical history from previous providers, hospitals, urgent cares, and even specialists that you may have visited. Having these previous records helps ensure we develop the best plan of care for each patient. 

Click here to download the ROI form if you are a patient or parent/guardian authorizing the release of your records to you or someone else. 

Click here to download the ROI form if you want records sent to Centerpoint Health. 

Transition Letters

Our Transition Letter is required to be signed by all patients who are between the ages of 12-14.  This letter explains how Centerpoint Health is here to help the youth transition from a "pediatric" patient to an "adult" patient.  We want to ensure we help these patients become more independent with their health care by taking the time to educate them one-on-one. 

Click here to download the Transition Letter.

Diabetes Prevention Program at the YMCA
Diabetes Prevention Program at the YMCA

REDEFINE YOUR HEALTH 

 TRANSFORM YOUR LIFE

Diabetes Prevention Program at the YMCA

• Classes starting October 15, 2020

• Program offered at no cost

• Must qualify to participate

Looking to improve your lifestyle and make a change? You can make changes that can reduce your risk for chronic disease and help you live a happier, healthier life. Change is tough--we can help!

PROGRAM FEATURES

• 25 sessions delivered over the course of one year.

• Led by a trained Lifestyle Coach.

• Accountability and encouragement toward reaching your goals.

• A group that offers motivation and support.

FOR MORE INFORMATION, CLICK HERE, OR PLEASE CALL:

1-937-531-4477

email: aschulze@daytonymca.org

Virtual option available for Centerpoint Health patients