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Intake Packet

In-Home Services
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In-Home
    Intake Packet

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Insurance
  ● TriCare Change
  ●TriCare UPDATE

  ● Retired TriCare -ABA 
  ●
Insurance Policy PDF

 
Is ABA Experimental?
 
Resources in seeking
     Insurance support for
     ABA services

Open Ga Autism List

Public Service

Referral Information

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Support Groups
  Open Ga Autism List

Testimonials

Articles  
  Sleep - Not Optional
  As a Parent - ABA
  Aspergers & Depression
  ABA, Retirees, and TriCare
  Briefing the Teacher
  Does RU Certify
        Therapists?
  BCBA-D What is it?
  BCABA - Independent?
  How to answer when
  insurance says ABA
  is experimental.
  EIBI and Cost
  "The Autism Puzzle"
  What is BCBA anyway?
  What is the ABLLS-R?
  ASD Evaluations
  SLP & ABA
  Sign vs. PECS
  Diagnosis-Eligibility
  Release Records
  NAS on Autism
  Sleep Tips
  Hire an ABA?
  ADHD or Sleep?
  Aggression
  Communication
  FBA
  NASP & FBAs
  Rx data sharing
  More than Rx needed
  Social Maladjustment
  A good Psych Report?

Links
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Behavioral

  Consumer Resources
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  Specific Disorders

 

Forms

All forms are available for download  in Adobe Acrobat format (PDF).  If you do not have the most recent version of Adobe Acrobat you can download it by clicking here.

 

At the Beginning

INTAKE PACKET FOR EVALUATIONS - Required

Intake Packet for In-Home ABA Services - Required

(The Intake Packets above include the individual forms listed below)

Authorization to Release Information
Brief Health Information Form
Consent for Assessment/Evaluation
Insurance Payment Policy
Payment Policy
Professional Services Fees
Records to Bring to an Evaluation

Authorizations to Release Information are not required for services but are required for us to acknowledge serving you or your child to any third party.  An Authorization to Release Information is NOT the same as requesting specific information, it merely is an authorization not a specific request.  Specific requests for records are handled as expeditiously as possible, however it is unrealistic to expect requests to be handled in less than one weeks time.

On-Going Data Collection

5 Minute Interval Form
15 Minute On/Off Task Form
ABC Data form (2 pages)
Communication Modes Table

Handouts

Compliance Training 
Pediatric Sleep Tips

Time Out Guidelines
What is Functional Communication Training



 

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