1-248-834-7790   |   sruffini@noac-ABA.com

North Oakland Autism Center

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Client Forms

Please see the links below for NOAC’s required intake paperwork. Please submit all forms before initiation of ABA Therapy. Please let us know if you have any questions about any of the forms.

Client Intake

Consent for Treatment

Client Privacy

HIPAA Notice
* Please print, sign, & return only the last page; to acknowledge understanding of our privacy policy.

E-mail + Text Consent

Permission to Videotape/Audiotape

Financial Agreement

Recurring Payment Form

Therapy Dog Release Form

Transportation Release Form

NOAC’s Drop Off & Pick Up Policy Form

Parent Goal Survey

Client Agreement for Center Based ABA Therapy

Finiancial Agreement Initial Page

North Oakland Autism Center

 
Phone: 1-248-834-7790
sruffini@noac-ABA.com

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North Oakland Autism Center

Phone: 1-248-834-7790

Email: sruffini@noac-ABA.com

Fax: (248) 622-5780

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“Students learn what you teach them,
not what you want to teach them.”

– B.F. Skinner

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