Complete Referral Form

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For Mental Health and Psychiatric Services, Please complete the form by clicking above.  Someone from the office will be in contact with you.  

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For ABA services, please read carefully

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Obtain a letter from your physician recommending ABA therapy.

 

Verify ABA therapy is covered by your insurance.

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Letter must include your child’s diagnosis

 

Fax: 407-386-8099

 

Email: referrals@claritybehaviorhealth.org