ATPF-GARD: Global Autism Resource Database Family Submission Form
This form is for families all over the globe who are looking for resources for their loved ones on the Autism Spectrum.
1. First & Last Name *
Your answer
2. Phone Number *
Your answer
3. Email Address *
Your answer
4. Country of Residence *
Your answer
5. Mailing Address *
Your answer
6. Name(s) & Age(s) of Children on Autism Spectrum *
EX: John, 5
Your answer
7. Name(s) & Age(s) of Siblings
Leave blank if not applicable
Your answer
8. Has your child been diagnosed on the Autism Spectrum? *
9. Is your child receiving any current therapy? *
10. What therapies is your child receiving? *
Required
12. Are you and your family interested in participating in ongoing clinical trials? *
Thank you for your participation!
Due to the nature of finding referrals across the globe, our goal is to contact you by phone or email in 5-7 business days with a referral for further resources.
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