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        Ohio Medicaid & Private Insurance

        The links below will provide the necessary forms in a reader friendly printable format. Completion of these forms does not guarantee approval of funding. For more information feel free to contact us at 1-888-884-2190.


        Medicaid / Private Insurance Packet



        Individual Forms: 
            Certificate of Medical Necessity
            Funding Checklist
            Funding Questionnaire


        Sample Reports:
            Autism
            CP
            CP & MR
            Downs_Syndrome
            Huntingtons
            TBI


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