Forms

Wraparound Referral Form

Wraparound (Child and Family Teams) is an intensive family based system of care. To learn more about this program, click here.

Toasty Tots Referral Form

Please click the PDF to the left to download the referral form for Toasty Tots this year. Please return forms to dholycross@logancbdd.org, fax to 937-592-7001, or mail to 1973 St Rt 47 W PO BOX 710, Bellefontaine

Early Intervention Referral Form

For children birth to three with potential or diagnosed developmental delays or disabilities. Early Intervention can offer Service Coordination and home visits.

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Contact Us

Tel: 937-292-3040

Fax: 937-592-7001

Address

1973 State Route 47 W.

PO Box 710

Bellefontaine, Ohio 43311