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    • Cash Assistance
    • Food Assistance
    • Emergency Assistance (PRC)
    • Child Care
    • Medical Assistance (Medicaid)
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    • Child/Adult Protection
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Forms

JFS Forms
APPLICATIONS
  • 7200 - Food Assistance and/or OWF Cash Assistance Application
  • 7216- Medicaid Only Application
  • 2399- Request for Medicaid Home and Community Based Services
  • 7204 - Reapply for Food Assistance and / or Cash Assistance Application
MEDICAL ASSISTANCE
  • Managed Care Providers
MISCELLANEOUS - BENEFITS RELATED
  • Authorized Representative Form
  • Declaration of self-employment income
  • Community Services Brochure
  • Employer statement
  • Explanation of State Hearing Procedures (4059)
  • IAR (Authorization for Reimbursement of Interim Assistance Initial Payment)
  • Interim Report 7221
  • LEAP Brochure
  • Ohio Direction Card brochure​
  • Program Enrollment & Benefit Information
  • Release form (HIPAA)
  • Release of Information​
  • Sanction Compliance Form
  • State Hearing Request Form (4069)
  • Tax filing status form
  • Zero income form
PRC
  • Prevention, Retention & Contingency Plan
  • PRC application
VENDORS OR CONTRACTORS
  • Vendor W9
  • Instructions
  • Ohio New Hire Reporting
  • Instructions
  • OPERS Independent Contractor Acknowledgment
Fairfield County
Job and Family Services

239 West Main Street
​Lancaster, OH 43130
OFFICE HOURS
Monday - Friday: 8:00AM - 4:00PM
After-hours appointments offered.
Drop box available at main entrance.

CONTACTS

740-652-7889 Main Line
800-450-8845 TOLL FREE
740-652-7856 OhioMeansJobs
740-652-7888 Child Support
740-652-7889 Community Services
740-652-7887 Protective Services

QUICK LINKS

  • Cash Assistance
  • Child Care
  • Child & Adult Protection
  • Child Support
  • Disability (Aged, blind disabled)
  • Emergency Assistance (PRC)
  • Employment
  • Food Assistance
  • Kinship, Foster and Adoption
  • Medical Assistance (Medicaid)
  • Transit "The Link"

JFS INFORMATION

  • Benefit Recovery Payment
  • Career Opportunities (JFS + County)
  • Contact Us
  • Forms
  • Leadership
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  • Newsletter
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  • Resources (Fairfield211)
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