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A completed Intake Form is required for all presentations to an Inter-Disciplinary Team and will be the only forms accepted in order for us to track data required by the state. Please complete the appropriate form below electronically and complete a separate Intake Form for each child presented. If you are unsure which form to complete, please contact Council’s Service Coordinator, Lori Babik at (440) 285-1203 or Lori.Babik@jfs.ohio.gov.
If you are requesting funding for a pro-social activity / goods & services:
Council should be considered the payor of last resort. Council funding is intended for multi-system youth living in Geauga County. If a multi-system youth is eligible for Medicaid, the family needs to apply for OhioRISE. While eligibility is being determined, you can apply for FFC funding. Future funding determinations will be dependent on following thru with the OhioRISE application.
Email the completed form, ROI, and supporting documentation a minimum of 2 weeks prior to the start date of the requested activity/service to Lori.Babik@jfs.ohio.gov AND Rachael.Tetlow@jfs.ohio.gov.
LINK TO PROSOCIAL INTAKE FORM
If you have an intensive case you'd like to present virtually to an Inter-Disciplinary Team [ie: Bridges, Crossroads, Engage, FFT, IHBT, MST, out-of-home placement, or a difficult case for direction/suggestions] :
Please contact Council’s Service Coordinator, Lori Babik at (440) 285-1203 or Lori.Babik@jfs.ohio.gov to discuss the case prior to filling out the intensive form.
Council can convene an Inter-Disciplinary Team meeting on Mondays at 10:30 am or Thursdays at 2:00 pm.
After you've talked with Lori, the intensive form must be filled out in its entirety and submitted a minimum of 5 business days prior to the scheduled presentation date set. Please email the completed form, ROI, and supporting documentation to Lori.Babik@jfs.ohio.gov AND Rachael.Tetlow@jfs.ohio.gov.
LINK TO INTENSIVE INTAKE FORM
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