Request An Appointment

Thank you for reaching out to Open Arms.

Please fill out the following form to request an appointment for advocacy. We will contact you within 3 business days to connect you with our services and answer any questions you may have.

If you need immediate assistance, please call 419-422-4766.

To schedule or inquire about supervised visitation services please call 419-420-9261.

Name *

Phone Number (including area code) *

When is the best time to reach you? *8:00 a.m. - 12:00 p.m.12:00 p.m. - 4:00 p.m.4:00 p.m. - 8:00 p.m.

Are you seeking an appointment withAn advocate (for support in the criminal/civil justice system)A support groupUnsure - I'd like to talk about my options

Do you need an interpreter?NoYes (ASL)Yes, in this language:

LanguageIf you selected Yes, in this language, please let us know above the language you prefer.

How would you like to be contacted?PhoneTextEmail

How would you like us to identify ourselves?Open ArmsThe doctor's officeOther:

Please Identify AsIf you selected other, please let us know above how you would like us to identify ourselves.

Can we leave a message if we get your voicemail?YesNoI don't have voicemail

OPTIONAL: Email Address

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Please be advised that due to confidentiality laws we cannot contact adults without their consent. If you are a parent, teacher or other caring adult for a survivor over 18, only fill out this form with their knowledge and full agreement. Thank you!