General Forms

​OhioPHP provides written reports on program compliance for those participants requesting updates. Communication with any third party is strictly prohibited and information is only released with written authorization. In order to process this request, please complete and return both forms below to: info@ophp.org or fax to (614) 469-9580.

 

For active participants, the cost of this request is included in the monthly monitoring fee. For any inactive participant who is no longer enrolled for monitoring and advocacy services, the cost of this report is $125.

 

Potential Participant Forms

​In order to complete a behavioral health screen or to enroll with the OhioPHP for monitoring services, you will be requested to complete a demographic and intake form. To request this, please contact info@ophp.org.

OhioPHP will also require discharge paperwork for any applicable treatment, verification of current medications, and other materials.

If you requesting consideration of a new volunteer peer monitor, please complete and submit the following form to info@ophp.org or your assigned case manager.

For more information, please contact OhioPHP at (614) 841-9690 or visit our FAQ.

Current Participant Forms

​On a quarterly basis, OhioPHP completes a Quarterly Status Report (QSR) documenting your compliance with your OhioPHP monitoring agreement.   In order for your report to be complete, you will need to provide the below documents.  Your materials will be due by the last day of the month corresponding with your assigned reporting period.  If they are not received by the due date, your quarterly report will be incomplete.

 

Please send your materials to info@ophp.org or your assigned case manager. If you have any questions, you can reach an OhioPHP team member at (614) 841-9690.

 

Self Report:

 

Volunteer Peer Monitor Report (VPMR):

Other Reports