Outpatient Care Referral

Outpatient Care Referral

Lighthouse Youth & Family Services is ready to answer your questions about outpatient services. Get connected with our team today.

Need more information? Call 513-487-6705 or send an email to [email protected].

Connect with outpatient services at Lighthouse Youth & Family Services.

"*" indicates required fields

Young Person's Name*
Young Person's Date of Birth*
Contact Name*
Contact Email Address*
Legal Guardian's Name if young person is under 18
Please select the service or services for the youth:*
Is an interpreter needed?
Max. file size: 50 MB.
Max. file size: 50 MB.