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SUBMIT A REFERRAL
For public agencies, health care providers, and families:
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Please use this form, at no charge, to submit a referral for the placement or services for a child or young adult.
The information is promptly sent to Ohio Children’s Alliance provider agencies and identifying information about the child (if present) is screened out. Please refrain from entering identifying information about the child.
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The provider agencies will contact you directly.
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