To make a referral to the FCF Cluster, the first two forms listed below must be completed and faxed to (513) 732-5414.  Click the form link to download a printable form.
 Cluster Forms:
  Cluster Referral Form
  Cluster Referral Form (Complete securely online)
  Release of Information
Must be signed by the parent/guardian. All agencies involved with the child/family should be listed on the Release of Information form, including the child’s school.
 Other Forms:
  CCBH/FCSS Initial Referral Form
Use the form to make a referral to access FAST or ABC services. Only children currently active with Cluster are eligible to received FAST/ABC services
  FCSS Respite Referral Form
  Wraparound Referral FAST TRAC Form

          Clermont County Family and Children First
                   1088 Wasserman Way, Suite B
                         Batavia, Ohio  45103
          Phone: (513) 732-5400    Fax: (513) 732-5414