Intake Form

Please fill out the information below about the individual seeking services. At the end of the form there will be a place to upload additional documents, including a referral for ABA services, copies of any diagnostic paperwork, and photos of your insurance card.

Once we receive all required documentation, an authorization request will be sent to your insurance in order to complete an assessment for services. Once that is approved, a BCBA will be assigned to your child and will be in contact about next steps.