Center Based Services

Registered Behavior Technicians (RBT) and behavior associates provide intensive teaching under the supervision of a BCBA.

Center-based instruction

Social Skills Group-Instruction: small, age-appropriate group instruction to build language, communication, and overall social skills

Community-based instruction

Develop skill acquisition programs

Language and Functional skills assessments

Implementation of behavior intervention plans.

Parent training: single and group options available

Social Skills Group Registration Form

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This field is for validation purposes and should be left unchanged.

Child's Name(Required)

First Last

Parent/Guardian's Name(Required)

First Last

Phone

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Date of Birth(Required)

Select Age Group(Required)

Ages 3-5

Ages 5-8

Ages 9-12

Do you plan to use health insurance?(Required)

Yes, I would like to use my health insurance

No, I would like to pay out of pocket

If you would like to use health insurance for our social skills groups, please fill out the information in the section below.

Subscriber's Name

First Last

Insurance

Front of Insurance Card

Max. file size: 64 MB.

Back of Insurance Card

Max. file size: 64 MB.

Copy of ASD Diagnostic Report

Max. file size: 64 MB.

Please use this space for any questions, comments or concerns! We will reach out with a confirmation of enrollment.