The department of job and family services shall adopt a standard form for the notice of medical support enforcement activity required by section 3119.35 of the Revised Code. All child support enforcement agencies shall use the form in issuing the notice under that section.
Standard form for notice of medical support enforcement activity
Ohio Rev. Code Ann. § 3119.352, under Chapter 3119 | Calculation Of Child Support Obligation - Health Insurance Coverage.
Ohio Rev. Code Ann. § 3119.352