Autism Services Registration

Please follow the instructions below to apply for CARE Clubs or ABA services.

Before you start your registration, you will need to log in or create a Heartspring account with a unique username and password. This ensures that your data is secure and allows you to save and return at a later time.


CARE Clubs

Click here for more information on CARE Clubs pricing.

STEP
1

Please fill out a new patient form to begin the process.
New Client Registration

STEP
2

Please download and complete the following application.
Heartspring CARE Clubs  

Email your completed form to our Heartspring CARE program at: CAREenrollment@heartspring.org

STEP
3

Once we have reviewed your registration, you will be sent an email with next steps.

Applied Behavior Analysis (ABA)

You will need to complete a new client registration to begin the registration process. Upon completion of the form, a Heartspring staff member will contact you to discuss scheduling options. Please feel free to contact us with specific questions.

Before your initial evaluation, we will need a physician order to oversee therapy interventions. Most therapies require an authorization for weekly therapy. Heartspring takes care of this for you but may require your assistance to ensure documentation from your primary care physician is received in a timely manner.

Click the link below to begin your registration.
New Client Registration

Use the links below to request a consultation, apply for financial assistance, or renew an existing registration.

Request A Consultation   Financial Assistance   Client Renewal Form

For more information on registering for Autism Services please contact:

Pamela Shadoin

Pamela Shadoin

Scheduling Coordinator

316-634-8724