Company Forms

Main Phone and Fax (907) 931-5548

Info@BehaviorIndependence.com

 

ABA Welcome Packet

In order to receive services with Behavior Independence, please complete the Welcome packet and submit to Info@behaviorIndependence.com

Please contact Info@behaviorIndependence.com to receive an easy to complete Adobe version of the Welcome Packet.

Clinical Screening

To complete the Clinical Screening please click the link to open in a new window.

Parent Handbook

Everything you need to know about your child’s services can be found in the Parent Handbook. Please be sure to review regularly.

Health & Wellness Policy

Policies in regards to your child’s health and wellness can be found here. If you have any questions please contact the Office Administrator at 907-931-5548 or Info@behaviorindependence.com

HIPAA Manual

Policies in regards to your child’s Health Insurance Portability and Accountability Act can be found here. If you have any questions please contact the Office Administrator at 907-931-5548 or Info@behaviorindependence.com

 

ROI

Release of Information can be found here. If you have any questions please contact the Office Administrator at 907-931-5548 or Info@behaviorindependence.com

Emergency Medication Authorization

If your child requires emergency medication please be sure to have your prescribing physician and yourself complete the attached form and submit to our Office Administrator at info@behaviorindependence.com

Request for Records

In order to request any of your child’s records from Behavior Independence, we require a formal request by completing the above Request for Records form and then submitting it to the Office Administrator at info@BehaviorIndependence.com