Clinical Intake

Fill out the form below to be placed on our waitlist for clinic based ABA services. Once all of the information on the form has been received and reviewed, our office will be in touch with you about the next steps in the process for assessment and ongoing services.

*please indicate preference for Chelsea or Trussville location on intake form

Items you will need to upload:

• Diagnostic Report (full report from diagnosing physician)

• Copy of Insurance Card (front & back)

• Referral or Script for ABA services (if required) from your pediatrician - can be faxed)

• IEP (if applicable)

• Outside Therapy Documentation (if applicable - Speech, OT, PT, etc.)

PLEASE BE ADVISED WE CURRENTLY ARE OPERATING ON A WAITLIST AT BOTH LOCATIONS. PARENT TRAINING IS AVAILABLE DURING THIS TIME. 

FOR ALL QUESTIONS REGARDING THE INTAKE PROCESS PLEASE EMAIL ADMIN@SIMPLIFIEDBX.COM OR CALL 205-210-9044

parents guide to aba therapy: 

what to expect with the intake process

Translation Services:

Should you require the services of a translator for either written or oral communication, SBH will make reasonable accommodations to assist with translation of services to the requested language. Accommodations will be made on a case by case basis, specific to the language.

SBH hará adaptaciones razonables para ayudar con la traducción de los servicios a pedido.

SBH fera des aménagements raisonnables pour aider à la traduction des services sur demande.

SBH jiāng gēnjù yāoqiú tígōng hélǐ de biànlì yǐ xiézhù fānyì fúwù.

SBH sẽ bố trí hợp lý để hỗ trợ dịch các dịch vụ theo yêu cầu.

SBH veiks saprātīgus pasākumus, lai pēc pieprasījuma palīdzētu ar pakalpojumu tulkošanu.

SBH примет разумные меры, чтобы помочь с переводом услуг по запросу.