Current Service Requests

Updated: 4/13/2012

Click on the "Service Request" links below to view or download:

• Service Request #7
• Service Request #8
• Service Request #9
• Service Request #10
• Service Request #12

Free Choice of Provider Instructions

Click on each “Service Request Form” separately to review. If you are interested in having your information forwarded to the individual/family for their consideration, please contact Rachel Rogers at rrogers@co.greene.oh.us Please clearly identify which request(s) you are interested in by referencing the corresponding number.

Note: To ensure that your contact information is accurately forwarded, it is important to keep your Provider Profile up to date on the Ohio Department of DD web site. To review your information or to make changes please visit dodd.ohio.gov (your username and passkword is required).

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