New client application
Apply for Autism services in Pennsylvania & Southern California by clicking on the button below. You will be redirected to our secure intake platform to begin processing your information. To help us secure a place on the waitlist, validate insurance, and ultimately match your child with an appropriate therapist please complete as much information as possible within the intake portal.
Both the form and website on the redirected site are secure and HIPAA-compliant. By completing this online form you agree to receive electronic communication from us. If you have any questions please reach out to intake@acclaimautism.com.