We Offer Behavioral
Health Training

We provide individualized training for schools, organizations, and professionals in the community. Topics can be tailored to the individualized needs of the person or organization. Examples include: Aba Teaching Strategies, FBA & Positive Support Plans, Understand Specific DX, or training tailored to the individualized needs or person organization.

IBHS Contact Form

Completion of the contact form allows your child to be reviewed for services in the future. Please specify whether you are looking for IBHS, Individual Therapy, Consultation or Social Skills Group services.

Your Full Name

Phone Number

Child's Full Name

Child's Address

Child's Date of Birth

Is The Patient a Minor?

Are you a New or Existing Patient?

List Available Days/Times You Are Available?

What service type of IBH service are you looking for?

Does your child require a written order/psychological evaluation?

Child's Medical Assistance Number (10 digit state ID number)

Does your child have Private Commercial Insurance?

Private Commercial Insurance Company name:

Private Commercial Insurance ID number:

Private Commercial Insurance phone number (located on back of Primary Commercial Insurance card for provider services or customer service or mental health):

Diagnosis (if known):

Does your child receive Early Intervention services?

Do you currently receive IBHS?

If so, with whom?

Does your child attend daycare?

If "Yes" what location and what days/times?

Does your child attend a school based program? (preschool/school age)

If "Yes" what is the location, and what days/times?

Does your child have any other regularly scheduled therapy sessions? (Speech, OT, PT)

If "Yes" what days/times?

Comments or Questions:

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We Offer Behavioral
Health Training

IBHS Contact Form

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We Offer Behavioral Health Training

IBHS Contact Form

Menu

Social

Website Design by Maverick Media

We Offer Behavioral
Health Training