Form – Submit Cash, Food, Medicaid Verifications and Case Changes ** If you have questions about your case, you must call 330-339-7791 and select option 2. ** Phone Client's First Name * Client's Last Name * Client's Email Address * Client's Phone Number * Client's Social Security Number * Client's Case Number Client's Mailing Address Client's Street Address Client's City * Client's State * Client's Zip Code * Type of changes and/or verifications: Address Change Name Change New Employment Change in Household Income Phone Number Change Change in Household Member Employment has ended Change in Household Expenses Other Please Explain Changes or Verifications File Uploads (PDF and JPG only) Click Here to Add Files - You can select multiple files. PDF files are the preferred type. Free apps to create PDF files can be found on the Google Android Play Store and the Apple App Store.