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Download, fill out, and submit either in-person, email or fax. Click each underlined item for the link to download. 

New Client Intake Forms

1 | Client Intake
2 | Client Handbook: Policy and


Please note additional documents may be required for insurance purposed. Additional documents required include, but not limited to:

  • Diagnostic report from Psychologist, specifying Autism (F84.0) *document must be within 3 years for most insurance plans

  • Recommendation or Prescription for ABA by a Psychologist, Developmental Pediatrician, etc 

  • Copy of all other evaluations (Speech, Occupational Therapy, Physical Therapy, etc.)

If in school: 

  • 504 or Individualized Education Plan

  • Full and Individual Evaluation (FIE)

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