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DIRECT Behavioral Strategies
We are ready to make a difference in your life
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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.