Client Intake Form
Filling out this form is the first step in our intake process that allows us to determine a timeline for service introduction. Your availability and location are the main factors that we are reviewing at this stage. We also ask that you input your current contact information, your child’s insurance details and any special considerations that are pertinent to your child’s therapy.
Benefits Verification
We use the information provided on the intake form to conduct eligibility and benefits verification. Autism Care West is a Participating Provider with Anthem Blue Cross Blue Shield, Aetna, UMR, Health Scope, UHC, Sierra Health & Life and Nevada Preferred Healthcare Providers insurance carriers. We are unable to accept Medicaid funding in any capacity. ACW also accepts ATAP funding for the Insurance Assistance plan.
Meet the Clinic Director, Founder & Owner
Following the first two steps, we invite you to come and meet with Charles Marriott to discuss our approach to ABA services & staff management; we want to ensure that all your questions are answered and that you understand the requirements of our program model before moving forward with our intake process.