top of page

Sovereign Solutions

Call: (419) 379-1779

HOME
COUNSELING
TRAINING
INTAKE
- LOG IN/OUT
- SCHEDULE
ADVOCACY
ABOUT US
SPONSOR
More

Use tab to navigate through the menu items.

Coming Soon...

Interest Questionnaire

Please fill out the following form.

First Name

Email Address

Phone

Last Name

Date of Birth

Gender

Address

Select your method of payment

Self pay

Insurance payment

Select the services you are interested in:

Child/Adolescent Counseling

Adult Counseling

Parent Education

Family/Educational Advocacy

Initials

Today's Date

I declare that the info I’ve provided is accurate & complete

Upload Government ID Card

Upload supported file (Max 15MB)

Upload Insurance Card

Upload supported file (Max 15MB)

Thanks for submitting!

© 2022 SOVEREIGN SOLUTIONS, LLC

Office Location:

Westgate, Toledo, OH 43606

Mailing Address:

PO Box #352198 , Toledo, OH 43635

bottom of page