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

We provide Behavioral Health, Dental, OB/GYN, Women's Care, Medical, Pediatrics, and Podiatry. We have ten locations and all can be found in Mansfield, Ontario, and Shelby, Ohio. Our main location is located at 600 West Third Street, Mansfield, OH 44906.

Share Your Success Story

I would like to tell how Third Street Family Health Services has helped me or my family.

This is your opportunity to share your experience with others. If you or a family member has received services at Third Street Family Health Services and you would like to share your success story, please fill out the following form.

Stories

To submit your story, complete the fields below.

Posting of stories

Stories may be edited for length and clarity. Not all submissions will be posted. Stories will be posted as space permits.

Story Submission Form

Name *
Name
Sharing of Information
By choosing to submit a story on the Third Street Family Health Services Web site, you acknowledge and agree that any information you provide, may be viewed by the general public. You further agree that Third Street Family Health Services may use your story in any manner it deems necessary or appropriate. Third Street Family Health Services reserves the right to edit, abridge or format stories for any reason and to remove or decline to post any story. Third Street Family Health Services does not endorse or make any warranties or representations with regard to the accuracy, completeness or timeliness of any of the statements in your story. *
Please choose all other options that you authorize Third Street Family Health Services to use
I consent to the taking and use of the photographs, films, audio and/or video, or publishing of the attached article or information as described above, including placement in central repository for use by any TSFHS affiliated health care providers, i.e. reuse, unless otherwise indicated. I understand that I may be identified in any use of the above materials. I realize that I will not be compensated in any way for the taking or use of photographs, films, audio and/or videotapes, or the publishing of the attached article or information. I understand and agree that this Authorization is valid unless I cancel it in writing (as described in the next sentence) for as long as the Organization noted above (or any organization that succeeds it) stays in business. I understand that I may cancel this Authorization at any time (as long Organization noted above has not taken action in reliance on this Authorization) by mailing, faxing or taking a letter in person to the organizations indicated above. I understand that once my health information is used or disclosed, it is no longer protected by state or federal law. I understand that neither TSFHS nor any of its affiliated health care providers can make me sign the Authorization as a condition of getting treatment, making payments on any bills, or gaining enrollment or eligibility in any health insurance plan, unless the Federal Privacy Regulations allow it. I understand that if the Organization noted above will receive money or other compensation (either directly or indirectly) from someone else because of the use of my health information in my project described above. I have been told of the compensation. I agree that I have received a signed copy of the Authorization. *
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Date
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Third Street Family Health Services is a FTCA Deemed facility

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