Type of Services Provided

• Behavioral Health
• Dental
• Mobile Dental
• Family Practice
• Vision
• Pediatrics
• Ob/Gyn

Required Documentation

• Proof of Income
  • Statement giving the amount of gross income per month if you are self or privately employed (if applicable)
• Proof of Residency
• Foreign ID

Contact Information

• Phone: 513-576-7700
• Address: 424 Wards Corner Road, Suite #200, Loveland, OH 45140

Note: Please contact HealthSource of Ohio directly for more information on their services, required documentation, and application process. 4/19 - Dental wait is 6mo-1yr

Links to Resource

• Link 1: **https://www.healthsourceofohio.org/sliding-fee-information/**
• Link 2: **https://www.healthsourceofohio.org/locations/**
• Link 3: **https://www.healthsourceofohio.org/services/dentistry/**
• Link 4: **https://www.healthsourceofohio.org/wp-content/uploads/2022/06/HR-116.1A-Authorization-for-Release-of-PHI-FORM.pdf**