If you are currently receiving CLINIC services thru Balance Autism, please do not register for this class. Instead, please contact your clinic director to see how we can implement these strategies into your loved one's current treatment plan.

PARTICIPANT INFORMATION

First Name

Last Name

Address

Address Line 2

City

State

Zip Code

Primary Phone Number

Email Address

Relationship to Individual with Autism

Which class do you wish to register for?

Loved One with Autism

First Name

Last Name

Age

ADDITIONAL PARTICIPANTS

Is there an additional person who will be attending this training with you? There is a limit of 2 per family.

Yes