Description of Services
A to Z Behavioral Services provides Applied Behavior Analysis (ABA) therapy to individuals diagnosed with Autism Spectrum Disorder (ASD) and related conditions. ABA is a scientifically validated approach to understanding and improving behavior. Services may include:
⦁ Functional Behavior Assessments (FBA)
⦁ Behavior Intervention Plans (BIP)
⦁ Skill Acquisition Programs
⦁ Parent/Caregiver Training
⦁ Direct Therapy under the supervision of a Board Certified Behavior Analyst (BCBA)
Consent for Treatment
By reading below, I:
1. Voluntarily consent for ABA services for my child/self.
2. Understand that ABA therapy involves assessment, goal setting, intervention, data collection, and regular review of progress with parent/guardian
3. Acknowledge that ABA therapy is individualized and requires active participation from family/caregivers.
4. Understand that services will be provided by a certified BCBA but may be delivered by either a behavior therapist or an RBT (Registered Behavior Technician).
5. Acknowledge that results may vary and no specific outcome is guaranteed.
6. Give permission for data collection and video recording (if applicable) for supervision, training, or treatment review purposes.
7. Understand that I can withdraw consent at any time by providing written notice to A to Z Behavioral Services.
I understand that state laws may require that confidentiality be broken under certain circumstances, specifically, if I am judged by the behavior analyst to be of danger to myself and/or others, gravely disabled, or if there is suspected child abuse (see mandated reporting agreement).
I also understand that A to Z Behavioral Services, LLC specializes in the evaluation and treatment of problem behaviors as well as skill acquisition, and if A to Z Behavioral Services, LLC is unable to meet my particular needs, I will be referred to an appropriate agency or individual (see discharge agreement).
Information will be limited to accommodate confidentiality with children of all ages. Family involvement is an important part of treatment. Children under the age of 18 will require a parent’s signature (or legal guardian) to receive any form of treatment.
Concerns may be directed to: 732-800-2869