Client Resources & Forms


To enroll in a specialized ABA program with me, I’ll need your completed student information, including the following forms. (Click to download in PDF, then return scanned, signed, and completed forms by email.)

  • Student information form
  • Emergency contact form
  • Strengths and needs assessment
  • (optional) IEP/Educational Needs Planning packet

Email completed forms to me and be sure to include your child’s name and the name of the form(s) in the subject line. 

Educational and ABA Program Tuition and Fees

I charge hourly rates, but these rates vary based upon the service needed. 

Additional expenses include those your child incurs during mutually agreed upon activities, such as admissions to community center, movie attendance, or a meal at a restaurant. I always look for the most affordable acceptable community-based services available, and we’ll keep your budget in mind. Going out into the world is an important facet of the life skills training your child will require in ABA—and to live a fulfilling life.

Educational services, including individualized tutoring and support services, are privately billed and do not occur through insurance. 

I do accept the following insurance for ABA services for individuals with an autism diagnosis, up to age 21. Please check with your insurance carrier for information on coverage and benefits.

Ready for an assessment? Contact me for a free consultation.