New ABA Client Form
Thank you for considering Freedom First Psychological Services for ABA services. Our ABA Program is currently full and we are maintaining a waitlist for potential new clients. Please complete the information below as accurately as possible so we can add you to our waitlist and reach out when a spot becomes available that will fit your needs.

Please note that our volume of new client inquiries is quite significant right now and we are not able to call to confirm that we've received your form or to provide frequent updates about your status on the waitlist. When we have a new client spot become available, we will be working through the waitlist on a first come first serve basis, using the information below to identify who would be a good fit for the availability. We will call/email you as soon as we are able to offer something.
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New York State requires individuals to have an autism diagnosis to receive ABA services. Does the potential client already have a diagnosis of autism? *
First and last name of the potential client: *
Date of Birth of the potential client: *
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Phone Number: *
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