Request Services

Who we serve

ABA Therapy Solutions provides behavioral therapy for children and young adults with autism and other related disabilities.

ABA Therapy Solutions clinics, provide ABA therapy.  Services are for toddlers through age 5 who are diagnosed with autism and other related developmental disabilities.

You can also request ABA services for In-Home,  or In-Community for toddlers through young adults. Our Board-Certified Behavior Analysts and Registered Behavior Technicians will accommodate services in a convenient location for you.

Request ABA Services by Form

Fill out the form below and click “Submit”

Request ABA Services by Form

Request ABA Service by Phone or Email

Contact Janine our Intake Coordinator by phone ext. 104 or email.

Request ABA Services-Janine Testa, RBT and Intake Coordinator

Fill out the form below to request services

  • Child's Information

  • MM slash DD slash YYYY
  • Focused treatment is typically 15-30 hours per week in the home. Indicate the time frames that you and your child are available for services in the home. Use the + sign for additional rows if availability is split throughout the day.
    MonTueWedThuFriSatSun 
  • Focused treatment is typically 15-30 hours per week in the home. Indicate the time frames that you and your child are available for services in the home. Use the + sign for additional rows if availability is split throughout the afternoon/evening.
    MonTueWedThuFriSatSun 
  • Drop files here or
    Accepted file types: jpg, pdf, png, Max. file size: 25 MB.
    • Parent/Guardian Information

      If parents are separated or divorced information for both must be provided.
    • Primary Insurance Information

    • Max. file size: 100 MB.
    • Secondary Insurance Information

    • Drop files here or
      Accepted file types: jpg, pdf, png, Max. file size: 25 MB.
      • Consent

      ABA Therapy Solutions is an ACE Provider and certified Safety Care trainers

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