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Intake Process Form

Client Intake Form

Please fill out this form to create an account with our records system–this is not the complete intake packet. You will receive an email to the address you provide with your login information and a second email with additional items needed to finish the intake process. Please be advised that this document MUST be completed and you MUST activate your account within 30 days of starting this process or your account will be inactivated in our system. If you are inactivated in our system you are more than welcome to reapply at any time if you can not complete the document within the 30 days of the original request.

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We deliver personalized, evidence-based treatments, including ABA, Occupational, and Speech Therapy, to support children and their families in achieving independence, growth, and an improved quality of life.

Form

Intake Process Form

Client Intake Form

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