ABA Therapy Form - Getting to Know You
Please note, these forms do not obligate you or SOS Care to ABA service. It is intended for the exchange of information only. Please complete this application in it's entirety.

To be considered active on our waitlist, SOS Care must receive a copy of your child's full comprehensive ASD diagnostic report and a copy of the front and back of all active insurance cards. If ABA Therapy is not covered then please include a letter from the insurance company stating that as well. These 2 items can be emailed to jhart@soscaresc.org , faxed to 843-712-1225 or mailed to 5276 Highway 17 BUS, Murrells Inlet, SC 29576. 
Sign in to Google to save your progress. Learn more
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of SOS Care. Report Abuse