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Referral Documentation Needed

Parents:  We do accept parent referrals for autism assessment, however, the more information we have in hand at the time of assessment, the better changes of your child receiving an accurate diagnosis. Therefore, please obtain as much of the information listed below as possible and bring with you to the appointment. You can fill out the referral at the bottom of the page by clicking the link and faxing or emailing it back to us.

Providers:  If you are referring a patient for autism assessment, please provide the following information along with the referral located in the link at the bottom of the page.

  • Referring provider’s developmental behavioral concerns, which should include:

    • Medical history.

    • Past evaluations from any developmental-behavioral pediatrics provider.

    • Specific office notes related to the developmental-behavioral concerns.

    • Records of any previously recommended treatments, such as outpatient developmental therapies or medications to address the symptoms of concern.

  • ADHD: Vanderbilt or Conners behavior rating scales.

  • Autism spectrum disorder: M-CHAT or Social Communications Questionnaire.

  • Global developmental delay: Developmental screenings, including Ages & Stages Questionnaire, PEDS or others.

  • Relevant school evaluations, including:

    • IEP.

    • 504 plan.

    • Integrated reports (IQ testing, psychoeducational evaluation, school academic testing, etc.)

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