Forms

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

New Client Intake Forms (4)

ADDITIONAL DOCUMENTAITON REQUIRED

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 or other 

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

If in school: 

- 504 or Individualized Education Plan

- Full and Individual Evaluation (FIE)