Request an Appointment

1. Completed CG&FS Admission Form
   Child Admission Form
   Adult Admission Form
   Please note, online admission forms need to be submitted 24hrs prior to appointment. You can also complete this at the Agency if you can come 45-60 minutes before your schedule appointment time. Completing it in advance will save you time.
2. Any insurance cards you may have, including Ohio Medicaid insurance cards.
3. Copayment for Services
4. If you are the legal guardian, please bring your Court papers, so we can make a copy for our records. (E.G., Power of attorney, adoption papers, custody documents or other court records, if applicable.)
5. To qualify for some free services and/or a sliding fee scale offered to Summit County residents, please bring the following information to verify your family income:
   -2 recent paystubs from each working member of the household
   -Child support information
   -SSI/SSD income information

• Children must be accompanied either by a parent/caregiver or legal guardian at the first appointment to consent to treatment and sign appropriate forms.
• Your first appointment will last approximately 1½ – 2 hours.
• A financial interview will be conducted to verify insurance coverage and payment arrangements.

If you need to cancel an appointment, please contact our Admissions Department at 330-762-0591 as soon as possible.