Parent/Guardian InfoParent's Name(Required) First Name Last Name Phone(Required)Email(Required) State(Required)Zip(Required)Child's InfoChild's Name(Required) First Last Date of Birth(Required) Month Day Year Child has Insurance(Required)YesNoDiagnosis TypeInsurance Type(Required)AetnaAnthemBlue Cross Blue ShieldCignaMedicaidOptumTricareUnited HealthcareOtherNo InsurancePreferred location for therapy(Required)CenterHomeUnsureHow did you hear about us?(Required)Healthcare provider - Primary/PediatricianHealthcare provider - Neuro/PsychiatristHealthcare provider - Psychologist/Case Manager/TherapistSchool or Childcare CenterResource Group/Community EventCurrent or Former ClientSearch Engine (Google, Yahoo, Bing)Social MediaInsurance Carrier/CMHOtherCAPTCHA Responding to you Our two-day promise An Acorn Health admissions representative will let you know we received your submission and will follow up with you within two business days. What you can expect Each potential client undergoes a phone screening, followed by an in-person consultation and individual assessment. For more information on insurance verification, payment options, and financial concierge services, please visit Insurance Costs and Considerations to learn more. Admissions representatives conduct the screening Our behavior analyst will co-create a treatment plan with each family Upon approval from the insurance provider, we will start services If you or your client provide your name and contact information, a member of the Acorn team will reach out to you upon admission, throughout treatment and upon discharge Why Acorn Health Our values People seek out those that share their values. Here are ours. Authenticity We present our true, consistent selves. Everyone hungers for genuine connections. Accountability We keep our promises, and can be trusted with the life and future of a child. Teamwork The best outcomes are produced by people who collaborate with enthusiasm. Growth We know the needs of children and their families are unique and ever-changing. Hustle In autism care and treatment, time is always of the essence. We do things now. The Acorn Approach With a Clinical Advisory of leaders in the field, we established five foundational pillars and a bedrock principle: accountability. Collaboration We’re in this together Individuality Your child is one of a kind Oversight We are accountable Outcomes What matters is progress Permanence We create lasting change Learn More Stay connected Please follow us on Facebook, Instagram, and LinkedIn.