We need some items from you before you fill out your intake form. This can be emailed to ksanger@sangerbehavioral.com or faxed to 863-583-0480:

1. A signed diagnosis from the Pediatrician, Neurologist, of Developmental Pediatrician who is a Medicaid approved Physician.
2. A comprehensive diagnostic evaluation (CDE) that shows assessments used to reach the diagnosis if the diagnosis is autism. Medicaid requires an evaluation report that indicates how the diagnosis of Autism was reached.  This report is usually completed by a Neurologist, Psychologist, or Developmental Pediatrician. The report must contain assessments used and scores from those assessments.
3. A signed referral specifically for ABA services
4. A copy of the child’s insurance card
5. Active IEP if in school services are desired