Parent/Guardian InfoParent's Name(Required) First Last Phone(Required)Email(Required) State(Required) Zip(Required) Child's InfoChild's Name(Required) First Last Date of Birth(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Child has Insurance(Required)YesNoDiagnosis Type Insurance Type(Required)AetnaAnthemBlue Cross Blue ShieldCignaMedicaidOptumTricareUnited HealthcareOtherNo InsurancePreferred location for therapy(Required)CenterHomeUnsure Responding to you Our one-day promise An Acorn Health admissions representative will let you know we received your submission and will follow up with you within one business day. What you can expect Our ten-day promise The journey is often long and parents are eager to begin. So Acorn Health makes a 10-day promise. For our early intervention program, parents will have an opportunity to meet with one of our clinical team members for a free consultation within 10 days of calling admissions. 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.