October 14, 2022
We want you to have access to all the forms you need for self-direction in Ohio. Check the list of basic forms below, and access all forms through your GT Portal account.
Select the buttons to jump to the forms that are right for you.
Basic Ohio Forms
| Participant Directed Goods and Services Request Form | Submit this form to request goods or services | Download Form |
| Participant Directed Referral Form | Submit this form to make a referral | Download Form |
| Referral and Enrollment Workflow | Overview of how referrals work from start to finish | Download Workflow |
| Hourly Rate Sheet for 2024 (DODD) | Approximate cost to your budget for employee pay starting 7-01-24 | Download Rate Sheet |
Self-Directed Transportation Forms
| Application and Attestation | Use this form to apply for self-directed transportation | Download Form |
| Card Program Agreement | Use this form to review and agree to the card program | Download Form |
| DODD Milage Log | Use this form to log your trips or mileage | Download Form |
| Lost Receipt Form | Use this form to report lost receipts | Download Form |
| Modified Vehicle Daily Inspection Log | Use this form whenever you use a modified vehicle | Download Form |
| Transportation Information Sheet | Use this to learn the ins and outs of SD Transportation | Download Form |
| Transportation Provider Certification and Steps | Use this to learn the steps to be a certified provider of self-directed transportation | Download Form |
| Transportation Purchase Request Form | Use this form to purchase transportation | Download Form |
Looking for more forms?
For a full list of forms, please sign in to your GT Portal account.
Don’t have access to a portal account? Get in Touch
Contact Us
Have questions? We’re here to support you.
Ohio Customer Service Team
Phone: 877.659.4500
Email: customerservice@gtsd.org