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Forms

Getting Ready for Your First Visit!

We are so pleased you are joining the ABA Clinic family! Just a few quick steps will help us get started with your services.

  1. Complete the Initial Client Information Form below.

  2. Review and sign the Terms of Therapy and Release Forms below.

  3. Send us a copy of your insurance card(s), if applicable.

  4. Send us a copy of your most recent behavioral assessment or ABA evaluation, if available.

  5. For children enrolled in a public school, please provide a copy of their current Individualized Education Program (IEP), if applicable, so we can better understand their educational goals and support needs.

We look forward to working with you and your family!

1. Initial Client Information Form

Before you begin, please have your insurance information, Medicaid number (if applicable), physician's contact information, and any relevant behavioral or developmental assessment records handy.

CLICK HERE TO BEGIN

2. Release Forms and Terms of Therapy Agreements

Click the Yellow Arrow on the left to complete the required fields and sign the necessary forms. It's that easy! Once you complete the form, you will receive an email to confirm your signature. Please be sure to complete this final step to submit your form to ABA Clinic. A copy of your completed form will also be emailed to you for your records.

3. Send Insurance Card Copies

Please email us a copy of your insurance card(s), if applicable, to help us verify your coverage before beginning services.

4. Send Evaluation Report

Please email us a copy of your most recent behavioral assessment, developmental evaluation, or ABA-related evaluation, if available, so we can better understand your child's needs and goals.

5. Send IEP Copy

If your child has an Individualized Education Program (IEP), please email us a copy of the current plan to help us coordinate ABA services with their educational goals and support needs.

Additional Forms and Tools

Prescription Form

We will be happy to request a prescription from our physician prior to your visit. If you would prefer, you can download our prescription form and share with them on your next visit!

CLICK TO DOWNLOAD

HIPAA Information

Curious about how we protect your private health information?  Here's the formal document describing our policies.

CLICK TO DOWNLOAD

Telehealth Agreements

Current ABA Clinic patients who would like to receive services through telehealth may need to review and sign the required consent forms before beginning or continuing remote sessions.

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Click here to complete the telehealth agreement online.

Existing Patient Updates

We want to ensure that we have the most up-to-date information for our current families. Please use the link here to update your contact details, physician information, insurance information, and any changes in your child's needs or ABA therapy services. Keeping your information current helps us communicate with you effectively and provide appropriate support.

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