Thank you for contacting us. This is the last of the information that is necessary to complete your enrollment with our agency.
Please review the enclosed information and complete the last page of information. Proof of family income and residency is required for enrollment into our sliding fee program. If you do not provide this information you will not be eligible for the sliding fee.
Should you have any questions while completing this information, please contact us at 440-285-3568 X303
Our Copeline is available 24 hours a day, 7 days a week for any mental health crisis. Copeline can be reached at 888-285-5665