Privacy & Consent

The information you provide on this form is confidential and is used solely to evaluate and process this referral for services at Option To Success Inc. It will be shared only with OTS staff directly involved in reviewing the referral and, where applicable, with the referring agency or provider named above.

Submitting this form does not enroll the individual named above as a client of Option To Success Inc. and does not guarantee admission into any program.

All information submitted is transmitted and stored securely. For full details on how we collect, use, and protect your information, please read our Privacy Policy.