For New Clients
The Initial Questionnaire Packet will need to be completed prior to scheduling an initial intake. You can bring all other completed forms with you or complete them during our first scheduled appointment when all the information is reviewed with you:
- Initial Questionnaire Packet
- HIPAA Form
- Consent to Treatment
- Financial Policy
- Patient Bill of Rights
- Release of Information Form
- No Show or Late Cancelation Policy
- COVID-19 Consent Waiver
For Providers
Thank you for referring to us. To start the referral process, please complete our referral form and fax it to (888) 965-0596, mail directly to the office or contact via phone.
ABC Data Form
It is important to identify the environmental events associated with the occurrence of problem behavior. This form will help you to identify what may be maintaining problem behavior and how to minimize and prevent problem behavior in the future.
NOTE: This is provided only as an additional resource for parents. Further training will be provided on how to collect ABC data and individualized modifications to the form may be made to collect data on specific behaviors.