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PenielHealthcare Services
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For SSAs, guardians and partners

Make a referral to Peniel

We are a certified Ohio DODD provider with same-day referral response. Tell us the essentials and we will come back to you with a clear yes, no, or when.

(513) 393-5166Email instead

Referral form

Send us the essentials

About you
About the referral
Please keep this minimal. Use initials only and leave out diagnoses, medication and any other health information. This form is not a secure channel for protected health information. We will collect what we need through a secure route once we have spoken.

Initials only, please. Not a full name.

Services requested

Select everything that applies. We will confirm what is authorised.

Logistics and coordination only. No medical details.

What happens next

Six steps from referral to first visit

No guessing about where a referral stands. You will know which step we are on and what is outstanding.

  1. Contact Peniel

    Send this form, call us, or email care@penielhealthcareservices.com.

  2. Share basic referral details

    Initials, county, services requested, funding source and timeframe. Nothing clinical.

  3. We confirm service fit and availability

    We tell you honestly whether we have the staffing to do this well.

  4. We coordinate with your support team

    SSA, guardian, family and any other providers already involved.

  5. Services begin after authorisation

    Once the Individual Service Plan and authorisation are in place.

  6. We stay connected

    Ongoing communication, accurate documentation and a named point of contact.