Request Services

How to Request Services from OhioGuidestone 

Please complete the form below to request services from OhioGuidestone. An Intake Specialist will contact you by phone within two business days of receiving your request.  

OhioGuidestone Request for Services Form

Please enter your 9 digit zip code in the xxxxx-xxxx format. If you do not know your +4 zip code, enter your address on this page at the USPS website.
For clients involved with Children's Services


If you'd like, you can PRINT A COPY OF THIS RECORD before submitting this form. You can also request a copy from your OhioGuidestone provider.

What does this form do? 

This form tells us what your needs are and helps us connect you with the right people as quickly as possible. At OhioGuidestone, we provide a complete continuum of prevention services and mental health and substance use treatment services throughout the state. This form helps us connect you with the right people and takes away the guess work.  

Who should complete the form? 

This form can be filled out by a person in need of services or someone requesting services on behalf of that person (parent, guardian, legal caretaker, health care or insurance provider, etc.  Please note we may ask for related legal documentation). 

Next Steps 

After you submit our Request for Services form, an Intake Specialist will assist you in taking the first steps by determining where you live, your availability, your specific needs and connecting you with a skilled professional who is best able to assist you.