'Contact Request Form'
What We Need From You
Are you ready to begin submitting?
If you have not yet submitted a 'Contact Request Form' online or over the phone, please do so before submitting the items outlined below.
Once a 'Contact Request' has been submitted, you are welcome to begin submitting the requested information and documents prior to receiving a call back. Though you may choose to wait until speaking with a director.
Not sure what step is next? Look them over at the 'Get Started' page.
Before we are able to schedule therapy services we must collect some information from you. The checklist is made up of documents & other files from:
Spectrum Therapy Center (forms and agreements)
Outside Sources, for example: pediatrician, previous therapy providers, evaluation facilities
Review the options below and select the checklist specific to your child.
Prospective clients interested in ABA/Social Skills AND other additional services need only to complete the ABA/Social Skills checklist
ONLY FILL OUT ONE CHECKLIST
Child has received ASD assessment, diagnosis and physcological report from a non-AAEC
Interested in ABA Therapy and/or Social Skills
ABA Therapy & Social Skills Checklist (Non-AAEC evaluated)
Optional: Speech Therapy , OT, Music
Optional: Interested in Speech Therapy, Occupational Therapy, and/or Music
Note: If interested in additional services after finishing intake process, notify your therapist
Interested in music related services
For Music Therapy and/or Lessons
Not interested in ABA, Social Skills Therapy, OT, or Speech, at this time
Music Therapy &