Use this form to submit your request to be included on the Clinton County Board of Developmental Disabilities provider’s page. You can view our entire provider list here. If at any time you want your information changed or removed please contact Leslee Culbert at 937-382-7519 x 1321.

Please attach a copy of your final certification letter from DODD and your agency logo or professional headshot photo.

Clinton County, Ohio Board of Developmental Disabilities Providers Submission Form

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