Paperwork required prior to scheduling ABA Intake:

 

The following paperwork is needed to complete the Request For Services form:

  • Full Diagnostic Report (Informe de diagnóstico completo)

  • Primary insurance card (Tarjeta de seguro primario)

  • Secondary insurance card (if applicable)

  • Previous services (e.g. birth to 3, speech, OT)

  • Current services (e.g. birth to 3, speech, OT)

  • IEP / 504 / ISP (if applicable)

  • Results of cognitive testing (may have been done through school)

Once you have requested services, we will reach out to you and may request the following paperwork be sent via email or fax:

If you are having problems with any of the forms or paperwork please click here to email the Intake Coordinator.