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Click Here to view Update of Openings. 1. Initial
phone contact: 419/868-117 2. Referral for outpatient Behavioral Health Services only may call: 419/ 868-1178 or follow Steps 1,3 & 4 3.
Fax or mail completed Referral Form along with the following information to: Attn: Mary Beth Olender;
Social History School Record, recent IEP Medical Records, Immunization Record Assessments and Psychological Evaluations Court Records, Police Reports Physical within 30 days prior to placement 4.
Review of referral information within 48 hours 5.
Identify homes which will present best match for youth 6.
Preplacement visits or interview 1.
Placement Agreements and legal documents including copies of birth certificate,
social security #, copy of medical records or judgment entries must be faxed to 419/ 868-1989 before youth
can be accepted. For youth to receive Behavioral Health Services: the
following is also required: Consent to Treat, Waiver of Confidentiality, and
Release of Information. 2.
Acceptance 3.
Set up placement date with the CTH Parents or CTHBH Intake Interview Youth up to age 18. Youth with a history of behavioral or
emotional problems. CTH cannot accept youth who present a serious threat to themselves, others, or to property. Those addicted to narcotics or alcohol are also excluded; though we will admit youth with substance abuse problems. Those requiring 24-hr awake supervision are not appropriate for GH/FH placement. In most instances, individuals who are non-ambulatory cannot be accepted; but, we will make every effort to accommodate special needs. Case / Service Plan Critical Incident |
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