Patient Intake Form
Call our office at 405-513-8186 with questions about the patient form!
What You Need To Know
Look Into Insurance
We are in network with Oklahoma Health Care Authority/SoonerCare/TEFRA, Blue Cross Blue Shield, Tricare, and HealthChoice. Call us to find out what your insurance benefits are.
We are currently accepting SoonerCare for ABA treatment. To begin services for your child, we will need a current prescription for ABA, a diagnosis of autism, and a copy of your child’s current psychological evaluation or diagnostic report. If you are interested in ABA services, please click the above link to complete our intake form.
Important Note: Each insurance company has its own unique protocols!
Do you have a prescription from an Oklahoma Physician?
If not, make an appointment to discuss why you feel your child needs therapy.
We will need documentation of the visit from your physician, including your concerns, any diagnoses, a prescription for services, and any visit notes. For OHCA/SoonerCare/TEFRA funding, a prescription and a copy of the visit notes will be required.
Many insurances do not require visit notes, but a prescription is always required.
What To Expect?
You will observe your child as they get to know the therapist
They will be asked to complete some activities and standardized testing if possible.
Some evaluations could take up to two hours to complete.
Other Information
Please bring with you child’s IEP or IFSP if they have one.
We are required to have parental or guardian of a child sign a consent to treat, so please attend the evaluation appointment with your child.
Our clinic’s goal is to not to have you and your child wait more than two weeks to get an evaluation appointment.