Annual Team Member DOcumentation 

Attestation and Agreement to Notify


This document is updated periodically by the Ohio Department of Developmental Disabilities and / or The Ohio Department of Medicaid. 

It is necessary for all team members to review the information contained therein so we all understand what may or may not be considered an offense that may affect your continued employment with PHCS. 

We don't expect this to be an issue, we're proud of the quality of our working staff and our Core Values. However, if you have a question or concern, please don't hesitate to contact the office at: 614-856-9111. Otherwise, review the document here, then sign the form and you're done for another year!

Instructions: 

  • Review the Attestation and Agreement Document by clicking on each of the page images below
  • Digitally sign the document and submit to PHCS by completing the form at the bottom of this page.