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Please fill out the fields below to submit an inquiry or service request to us electronically.

Within 24 hours, we will review your information and get in contact to discuss how we can help.

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Does your child currently have an autism diagnosis?

Has your child had a Comprehensive Diagnostic Evaluation completed?

If yes, does the Comprehensive Diagnostic Evaluation include an ADOS, CARS or other structured assessment?

If yes, please Provide the Name of the Provider and / or Their Practice That Conducted the Evaluation:

If yes, in What Year Was the Evaluation Completed? (Approximate Is OK.)

Who Is Your Insurance Carrier?

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