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    • Home
    • Autism Evaluations
    • In-Home ABA Services
    • Contact us
    • About US
    • Employment
Family Strong CT
  • Home
  • Autism Evaluations
  • In-Home ABA Services
  • Contact us
  • About US
  • Employment

Referral and Service Request Form

Referrals for Autism Evaluations can be made by any individual.  

Click HERE to complete our Autism Evaluation referral form online.


Para completar nuestra referencia en español en línea, haga clic en
AQUÍ.


Si requiere asistencia en Español comuníquese con Yachira Rosario Diaz al 203-920-0520 ext. 1064


We accept Husky A, C, and D. We are out-of-network for all other insurances.


 Or, download the referral form below and fax it to us at 203-266-1005. You may also email the referral form to sara.brown@familystrongct.com. 

English- Family Strong CT ADE Referral Form (pdf)

Download

Spanish- Family Strong CT ADE Referral Form (pdf)

Download

Contact Us

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Office Locations:

North Haven Office: 605 Washington Avenue North Haven, CT   

Southbury Office: 220 Main Street S. Suite 206A Southbury CT

Phone: 203-920-0520 Fax: 203-266-1005

Hours

By appointment. Please email or call us to schedule an appointment.


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