Thank you for your inquiry about our ABA services. Please follow the instructions to submit the Insurance Intake Form to see if we can provide services to your family.
1. Download the Insurance Intake Form above (Blue Button)
2. Fill out the form as best as you can
3. Upload form to the upload link below
4. Click on the "Submit" button
5. Your done! An SSPBI representative will contact you that we received your submission and start the process for services.
Insurance Intake Form
Easter Seals partnered with Kaiser Permanente patients please contact your case manager to inquire about services with SSPBI!
All other insurance patients please fill out the below form:
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