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ABA Therapy for Children With:




Dev Disabilities

Asperger's Syndrome

Behavioral Concerns

African American Mother with Daughter
Family Having Fun

Referral Form

If you're ready to start ABA therapy, and would like to know if your insurance will cover recommended hours, complete the following form and scan/email or fax back to us.  

If you are using a state Medicaid HMO plan, you will need to get a letter from your child's doctor stating the following information:

1.  Child's Name

2.  Child's Date of Birth

3.  Diagnosis

4.  Says "ABA therapy is medically necessary"

5.  Signed by an MD

Once the referral form and the doctor's letter are received, we can submit a request for an assessment authorization and set up the intake/assessment.


Schedule Appointment

Start your new path in life and be the change today!

Helpful Forms

Click here to view and print forms for your appointment.