HOURS

MONDAY-THURSDAY

8:00AM-5:30PM

 

Friday

8:00AM-2:00PM

 

​SATURDAY-SUNDAY

​Closed

 

 

 

CONTACT​ US

1700 Thomas Paine Parkway

Centerville, OH, 45459

 

synergyfamilytherapy@gmail.com

Phone: 937-428-6273

Fax: 937-428-6274

 

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Patients

As a new or existing patient at Synergy Family Therapy Specialists, you will have to periodically fill out forms when you arrive to help us keep our records up to date. You can assist in this process by downloading the forms ahead of time and filling them out before you come in for your appointment. This page contains links to downloadable versions of our most frequently used forms.

 

New patients - please download, print and fill out all of the intake paperwork forms, and bring them to your first appointment. Please note, we have two sets of intake paperwork forms. One is for Pediatrics (Under 18). The second is for Adults (18 and over). Please complete the most approriate form.

 

 

 

The Pediatric Intake Paperwork is for patients under 18.

 

 

 

The Adult Intake Paperwork is for patients 18 and older.

 

Returning patients - if there have been any changes to your information please download, print and complete the section that changed.

 

 

 

Physicians

If you have a patient that would benefit from Physical Therapy, we would love to help them reach their goals. Attached is a copy of our Referral Form that you can print, complete, and fax to us. We will contact the patient and set up their first appointment. Please fax your referrals to 937-428-6274.