NAVIGATION

 

 

Applying for Home-based ABA Services

Thank you for your interest in our home-based Applied Behavior Analysis (ABA) services. In order to effectively assist you in accessing services for your child, we ask that you complete the documents included below and return them with the following documentation:

  • Completed application [download here]
     
  • Insurance form [download here]
    **Please be sure to include information for ALL insurance plans your child may be covered under
     
  • A copy of your child’s insurance card (front and back)
    ** Please be sure to include copies of cards for ALL insurance plans your child may be covered under
     
  • A diagnosis letter from your child’s physician or licensed mental health provider specifically stating your child has a diagnosis of Autism (if the diagnosis letter is older than 6 months, please provide a copy of the physician’s record or mental health record reiterating the diagnosis)
     
  • If you have MassHealth, a copy of your child’s entire diagnostic report
     
  • A copy of your child’s most recent physical exam and up-to-date immunization record
     
  • A copy of your referral or recommendation for ABA services from your child’s primary care physician, psychiatrist, or psychologist (as applicable to the insurance company)
     
  • A copy of your child’s up-to-date IEP, if applicable

To ensure your privacy, please return this information via fax or standard U.S. mail to the fax number or address listed on the May Center office closest to you: