Core Clinical Services ABA - Group Services Waitlist Request

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Core Clinical Services ABA - Group Services Waitlist Request

Updated: October 21, 2025

We will review your information to see if you are eligible for our group services. After reviewing, we may schedule a short virtual meeting with you and your child. If you are eligible, we will contact you to discuss registration and next steps. If not, we’ll reach out to share other options.

Group Participant Interest List

If a group isn’t available right now, we are collecting names of interested participants so we can plan future groups once enough families are interested. If you are interested in a group, please also let us know your preference for virtual and/or in-person options.

Today's Date

YYYY

Child's name *

Child's date of birth *

YYYY

Age

Parent/Caregiver Name

Your phone number *

Your email *

Home address

Which group/s are you interested in your child attending:

PEERS Social Skills Group for Teens

Employment Readiness Skills Group for Teens

STEM Explorers: Building Collaboration and Problem-Solving (IN-PERSON only)

Game Masters: Enhancing Social and Group Problem Solving Skills (IN-PERSON only)

Friday Night Hangout: Social Skills Generalization Group (IN-PERSON only)

Preferred location of services (select all that apply)

In-office/in-person

Virtual

In community

Do you have access to OAP funds and will be using them to pay for this service? *

Yes

No, I will be paying using personal funds

If you do not have OAP funding but are currently on the OAP waitlist, would you be open to our Foundational Family Services – Brief Consultation? This is a free, short-term caregiver coaching service to help support your child’s goals.

Yes, please contact me regarding next steps

Maybe, I will need more information

Clear selection

For in-person groups, this service will require drop off and pick up from 917 Nipissing Road, Milton. Are you able to drop off and pick up your child?

Yes

Clear selection

Tell us about your child, what are their likes/dislikes, interests, preferred activities etc., *

Does your child have other diagnoses (medical, physical, psychological etc., such as ADHD, OCD, ODD, Cerebral palsy, epilepsy, FASD, Fragile X or others not listed)? *

Yes

If yes, please provide details below on the diagnosis, any medications your child takes, or if your child will need any accessibility aids during their day:

Does your child communicate independently? *

Yes

How does your child communicate? *

Verbally

PECS

Speech Output Device (e.g., iPad, Go Talk)

Sign Language

By pointing and leading

No-tech communication boards, pointing at pictures, Flip and Talk etc.,

Other:

If your child attends school, check off all that apply below:

Child attends mainstream classroom without support of an Educational Assistant

Child is in a special education or life skills program at school

Child has access to an Educational Assistant who supports other children as well (shared support)

Child has 1:1 support from an Educational Assistant

Child is home schooled

Other:

Check below all that apply to your child: *

My child requires 1:1 supervision

My child can toilet independently

My child can communicate when they need to use the toilet

My child can sit and attend to a lesson for at least 15 minutes

My child can sit and attend to a lesson for at least 30 minutes

My child typically gets along well with peers who are the same age

My child can engage in a group setting (up to 8 peers) without engaging in challenging behaviours (e.g., aggression, self-injury, elopment)

My child can stay with a group when out in the community (e.g., at parks, on walks, in the grocery store)

None of the above applies to my child

Required

In the past year has your child engaged in any of the following? *

Physical aggression (e.g., hitting/kicking/slapping others or motioning to do so to others)

Verbal aggression (e.g., yelling, threats, swearing at others)

Elopement (leaving an area they are not supposed to)

Self-injurious behaviour

Property destruction

Spitting (at others or where spitting would not be expected)

Unexpected voiding in public spaces (going pee or having a bowel movement outside of a toilet)

Stripping (removal of clothing in public spaces or where not expected)

Touching others inappropriately (include touching others who have not asked to be touched/hugged)

None of the above

Required

Use the space below to provide further details on any of the checked boxes from above: *

If you have any questions, or additional information you would like to provide, please complete below: *

Group Participant Interest List

Would you be open to us keeping your contact information and reaching out when a suitable group is available (for example, when we have enough participants with similar goals and availability)?

Yes

Other:

What type of group format are you interested in? Check all that applies

Virtual

In-person

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