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

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

Para completar este formulario en español, haga clic aquí.

  • 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