Request Services

How to Request Services from OhioGuidestone 

You may 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

For clients involved with Children's Services

Funder/Payor/Contract

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 offer a range of services throughout the state. This form helps us connect you with the right people and take away the guess work.  

Who should complete the form? 

This form should be filled out by the person in need of our services or who needs to get in contact with us. If the person cannot fill out the form (such as a minor or someone with a disability) a parent, guardian or legal caretaker may complete the form. 

Next Steps 

After you submit the form, our intake specialists will review to determine who can best help. This will depend on where you live, your availability, your specific needs, and who is available to assist you.