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FORMS

Disclaimer:

These forms collect background information to assist with planning non-medical residential supports (such as dietary preferences, medication reminders, and routines). AFLH does not provide clinical or therapeutic services.

Class Two Facility Resident Health Assessment 

Residential State  Supplement (RSS) Program Application

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© 2025 AFLH Behavioral Health Services. All Rights Reserved.

LEGAL & LICENSING DISCLOSURE

AFLH is a CARF-accredited, OhioMHAS-licensed, and OhioMHAS-certified Behavioral Health Agency authorized under Behavioral Health Certification #01-9241 to provide adolescent behavioral health services, including residential and community-based programs.

AFLH complies with HIPAA, 42 CFR Part 2, and all applicable state and federal nondiscrimination laws.

TEL: 614-808-1011

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FAX: 614-706-7388

1005 East Long Street, Unit B

Columbus, Ohio 43203, United States

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