IPS Parent Training Sign-Up

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Sign-up to attend our IPS Parent Training for Disruptive Behaviors 8 week sessions. The training is a step-by-step guide to help improve care for families and children with autism, ADHD, and related diagnoses (e.g., oppositional defiant disorder, disruptive mood dysregulation disorder, anxiety, etc.).

The cost of the training is:

$250 paid in full at the beginning. Reach out to our office staff if you'd like to request our Sliding Fee Application form to apply for a reduced rate.

You can choose to have us bill your insurance. Parents are considered the client, and parents will need to have active insurance for us to bill for services. Insurances accepted include: BCBS, MS Medicaid products (Straight, UHC, Magnolia, and Molina), UHC Commercial, Cigna, and Tricare.

NOTE: This training will all be conducted virtually, unless otherwise requested. We hope to offer in-person options starting summer 2024.

NEW GROUPS BEGINNING regularly:

Wednesdays @ 2:00 starting April 3rd (and running 8 weeks, minus holidays)

Monday @ 5:30 starting on April 8th, 2024 (and running 8 weeks, minus holidays)

Email *

First Name *

Last Name *

Parent's Date of Birth (to create a patient portal for new patient paperwork) *

YYYY

Best Contact Number *

Age of Child(ren) *

Behaviors to address during parent training *

Which session/group would you like to register for? If you would like to register for the next available session, please select the days/times that you are available. *

Mondays at 5:30 pm

Wednesdays at 2:00 pm

Required

Additional add-on topics available following your group training include (select all that you are interested in): *

Token Economies

Feeding Problems

Imitation Skills

Sleep Problems

Time-out from Reinforcement

Toilet Training

Crisis Management

None

Required

Do you plan to use insurance or do self-pay? *

Yes, I would like to use my insurance (you must be located in the state that provider is licensed at the time of the appointment- MISSISSIPPI)

No, I will self-pay $250 for the complete series.

What is the parent's insurance? *

BCBS Commercial (no Tennessee Medicaid products)

Straight MS Medicaid

UHC Medicaid

Magnolia Medicaid

Molina Medicaid

UHC Commercial

Ambetter

Tricare

My insurance is not listed, I understand I will owe $250 for the series

I am self-paying, and agree to pay $250 for the series

Insurance Member ID# (put N/A if self-pay) *

Any additional comments/questions

A copy of your responses will be emailed to the address you provided.

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