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New Family Intake

Let's Get to Know Your Family

This form takes about 5 minutes to complete. Once submitted, we'll review your information and reach out within 2 business days to schedule a free consultation call.

Not sure if ABA is right for your family? Read our FAQ first →

What happens next

Your Path to Getting Started

1

Submit This Form

Tell us about who you're seeking services for and what you're hoping to work on. 5 minutes, no commitment.

2

We Review & Reach Out

We'll read your intake and contact you within 2 business days to schedule a consultation.

3

Free Consultation

A relaxed 30-minute call to discuss the individual's needs, answer questions, and see if we're a good fit.

4

Assessment & Program

We conduct a formal assessment and build an individualized program tailored to the individual.

1
Caregiver
2
Individual
3
Services
4
Funding

Step 1 of 4

About You

Tell us a bit about the caregiver or person submitting this form.

Helps us determine if we can serve your area.

Step 2 of 4

About the Individual

Share some background on the individual who would be receiving services.

Step 3 of 4

Services & Availability

Tell us what type of support you're looking for and when you're available.

Step 4 of 4

Funding & Final Notes

Help us understand your funding situation so we can point you in the right direction.

Your information is kept strictly confidential and used only to prepare for your consultation. We will never share your details with third parties. By submitting this form you consent to Continuum ABA contacting you about our services.
Step 1 of 4