If you are a parent or guardian, please refer to the Make an Appointment form.

To learn more about our programs and approach, click here.

If you prefer to download SVFS’ professional referral form, click here. Complete and return by email to intake@svfc.org or fax at (614) 255-5759.

Click here to download our referral form in Spanish.

  • Referring Agency

  • Please download and attach our Release of Information Form and any additional documents to support your referral* (any information from the child's file, IEP info, behavioral documentation from the school, etc.)

  • Accepted file types: pdf, doc, docx, Max. file size: 50 MB.
  • Accepted file types: pdf, doc, docx, Max. file size: 50 MB.
  • Accepted file types: pdf, doc, docx, Max. file size: 50 MB.

  • Child Information

  • MM slash DD slash YYYY

  • Additional Child Information

XS <576px
SM ≥576px
MD ≥768px
LG ≥992px
XL ≥1200px
XXL ≥1400px