The Intake Coordinator is available to discuss:

Centre Syracuse Treatment Programs
Determining the level of care needed
Admission Procedures
Living Arrangements
Treatment Costs
Verification of insurance benefits
Working with your existing professional treatment team
Lengths of stay

First Step in Being Considered for Possible Admission
The first step in being considered for possible admission to the Partial Hospital Program is to complete the Initial Information Form indicating the nature of your problems. Completing this Initial Information Form will enable us to discuss the most appropriate treatment alternatives with you. The information you provide on the Initial Information Form is confidential and will only be reviewed by the Centre Syracuse Intake Coordinator and senior clinical staff in order to assist you in exploring treatment options.

Filling out this Initial Information Form does not obligate you to treatment. After completing this on-line form using the secure website screens below, if you decide that you are not interested in receiving treatment at Centre Syracuse all identifying information will be permanently removed from your record.

The Next Step:
After we have received your Initial Information Form, the Centre Syracuse Intake Coordinator will contact you by e-mail or by telephone (or you can contact her at 315-671-2202) to schedule a comprehensive phone or face-to-face interview. This meeting will be used to gather information about the history of the eating disorder and previous treatments as well as psychological, social, family and medical factors that play a part in the current symptom picture. The Intake Coordinator will also provide you with answers to any questions you have regarding the program.

We understand that you may wish to speak confidentially, so we will not call you unless you give us permission and times that you will be available. At the end of the Initial Information Form, you will be asked to specify one of the following methods of contacting you:

Contact me by e-mail at the following e-mail address: ____________________________
Call me at this telephone number: _________________________
___Anytime
___Only on the days and times checked below:
___Preferred Days (check all that apply): _ Mon _ Tues _ Wed _ Thurs _ Fri
___Preferred time: Between __:____ am/pm and __: ____am/pm

___ You may leave a message
___ Do not leave a message

___ Do not call me- I will call you.

Now, please complete the Initial Information Form by clicking on continue.