As a new client we ask that you print and complete the following new client paperwork (intake assessment) before visiting our facility. Please CLICK HERE to access the intake assessment.
In addition to the intake assement form please print and fill out the: Consent to Release Billing Form. CLICK HERE for form.
Once you have printed the information and filled out the form you can:
- Bring to our Main Office, 104 Spink Street, Wooster, Ohio or our Millersburg Location, 34-C South Clay Street, Millersburg, Ohio
- Email it to: firstname.lastname@example.org
- U.S. Mail the form to: OneEighty, 104 Spink Street, Wooster, Ohio 44691
- Or call us at 330.264.8498 to complete the form over the phone.
OneEighty is operating on modified hours. Please CLICK HERE to view our hours.
Also visit our COVID-19 Update page CLICK HERE for steps we are taking for the health and safety of our clients and staff.
Click HERE to view OneEighty Client Welcome Packet.
Click HERE to view OneEighty Consent for the Release of Information. Please fill out completely and send with your new client assessment paperwork. Call our Main Office: 330.264.8498 for more information.
Click HERE to view OneEighty Telehealth Informed Consent.
Click HERE to view our Sliding Fee Scale.
Click HERE to view our Fiscal Policy and Procedure for Service Reimbursement.