Submit a Referral · Adams Behavioral Consulting

Get started

Where are you in the process?

Families, schools and providers all welcome

For families

Complete your intake online

Fill out your intake on any phone or computer, and sign online where needed. No printing or scanning. About 20 minutes.

Start your intake

For schools, providers & others

Send a referral

Tell us a little about the person who needs support, and attach any documents. Our team will reach out about next steps. About 5 minutes.

Start a referral

Your information is sent securely and goes only to our team. You'll get a confirmation by email.

Not for emergencies. These forms are not monitored around the clock. If someone is in danger, call 911. For a mental health crisis, call or text 988 (Suicide & Crisis Lifeline).

Step 1

Send a referral

A few details so the right person can reach you

Who is making this referral? *

School name *

Practice or organization *

Type of provider *

Relationship to the person being referred *

Agency or organization (if any)

Your name and titlerole *

Your phone *

Your email *

Fax (optional)

Which program are you looking for? *

Applied Behavior Analysis (ABA) Behavior Support Services (NOW/COMP)

Not sure? Compare the two programs. The operations director for the program you choose will contact you about next steps.

Information about the person being referred

First name *

Last name *

Date of birth *

School (if any)

Main contact (parent, guardian or caregiver; if you're referring yourself, enter your own details)

Full name *

Phone *

Email *

Goals for therapy (check all that apply)

Challenging behaviors Communication & language Toilet training Food selectivity Sleep Community & social skills Daily living skills School support

Tell us a little more

Documents Choose files to upload Diagnosis, insurance card, school plans · PDF, Word or photo