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Alaska Association for Behavior Analysis
Voluntary Organization Information
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Organization / Agency Name
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Mailing Address
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City, State, Zip Code
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Phone Number
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Email Address
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Organization Website
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Please briefly describe the organization for people who want to know more about it.
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What services do your organization offer?
Applied Behavior Analysis
Speech / Language
Occupational Therapy
Parent / Caregiver Training and Support
Other:
What age groups do you serve?
0-3 years
3-5 years
6-10 years
11-14 years
15-18 years
18-21 years
21+ years
Other:
In which setting(s) are your services available?
Clinic
Home
School
University
Community
Hospital
Online / Telehealth
Other:
Which funding sources do you accept?
Private pay
Private Insurance
Military Insurance
Medicaid
Other:
Is the organization currently accepting new clients?
Yes
No
Maybe
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