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Make a Referral

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Participant Portal

Please submit all documentation to info@ohiophp.org or via fax at (614) 469-9580. For any questions, please contact your case manager or info@ohiophp.org.

Release of Information

Schedule Toxicology Test

FORMS

Participant Forms

Self Report (Substance Use Disorder)

Self Report (Mental/Behavioral Health)

Advocacy Request Form

Monitor Forms

Monitor Report (Substance Use Disorder)

Monitor Report (Mental/Behavioral Health)

New Monitor Application (Substance Use Disorder)

New Monitor Application (Mental/Behavioral Health)

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