Third Street Family Health Services - Behavioral, Dental, Medical, OB/GYN, Podiatry, Pediatrics, Suboxone, 44906, 44875

We provide behavioral health, suboxone, dental, OB/GYN, women's care, medical, pediatrics, and podiatry. We have nine locations and all can be found in Mansfield or Shelby, Ohio. Our main location is located at 600 West Third Street, Mansfield, OH 44906.

OB/GYN Resources

New Patients

Welcome to TSFHS OB/GYN. In order to prepare for your first appointment with us, here is some basic information and forms to have ready:

General Information

  • For your first appointment, you should expect to be here for up to 2 hours. However, if you can manage to bring in the completed forms below, that time will be greatly reduced.
  • Your first appointment will establish you as a new patient. Subsequent appointments will be made for care from one of our providers.

Items Needed at First Appointment

  • Social Security Number
  • Shot Records (Children)
  • Identification (Drivers License, State ID Card, Social Security Card)
  • Letters of Court-Appointed Custody or Guardianship, If applicable
  • Medication List or Pill Bottles
  • Insurance Card
  • If no Insurance, Proof of Household Income will be required to apply for Sliding Fee:

Proof of Household Income Includes:

You must bring in ALL items that apply to your house-hold

  • Proof of Alimony
  • Pay Stubs for the Past 30 Days
    • We will NOT accept bank statements.
    • We will NOT accept W2′s as proof of income.
  • Unemployment or Workers Compensation award letter or check stub
  • Social Security, Disability, or Retirement award letter
  • Veteran’s Benefits
  • Pension check stub or award letter
  • Letter from Employer
  • ADC Income
  • Letter from anyone providing you with financial support, this includes housing and food
  • If the patient is self-employed – full tax return with schedule C

Downloadable Forms

Educational Information

OB/GYN Resources

New Patients

Welcome to TSFHS OB/GYN. In order to prepare for your first appointment with us, here is some basic information and forms to have ready:

General Information

  • For your first appointment, you should expect to be here for up to 2 hours. However, if you can manage to bring in the completed forms below, that time will be greatly reduced.
  • Your first appointment will establish you as a new patient. Subsequent appointments will be made for care from one of our providers.

Items Needed at First Appointment

  • Social Security Number
  • Shot Records (Children)
  • Identification (Drivers License, State ID Card, Social Security Card)
  • Letters of Court-Appointed Custody or Guardianship, If applicable
  • Medication List or Pill Bottles
  • Insurance Card
  • If no Insurance, Proof of Household Income will be required to apply for Sliding Fee:

Proof of Household Income Includes:

You must bring in ALL items that apply to your house-hold

  • Proof of Alimony
  • Pay Stubs for the Past 30 Days
    • We will NOT accept bank statements.
    • We will NOT accept W2′s as proof of income.
  • Unemployment or Workers Compensation award letter or check stub
  • Social Security, Disability, or Retirement award letter
  • Veteran’s Benefits
  • Pension check stub or award letter
  • Letter from Employer
  • ADC Income
  • Letter from anyone providing you with financial support, this includes housing and food
  • If the patient is self-employed – full tax return with schedule C

Downloadable Forms

Educational Information

Background Designed by Freepik

Third Street Family Health Services is a FTCA Deemed facility

© 2015 Third Street Family Health Services All Rights Reserved Designed by TSFHS