I Have an Autism Diagnosis
Use this form to apply for services with Affinity Autism Services.
I Don't Have an Autism Diagnosis
At this time we only offer ASD diagnosis for individuals who have Medicaid that are 18 years old or younger.
Our Intake Process
We keep our process simple, with our staff guiding you step-by-step.
1
INTAKE FORM OR INITIAL CONTACT
Fill out our contact form to start the conversation with us.
2
EVALUATION AND INSURANCE INFO
Gather autism evaluation and insurance information.
3
BENEFITS CHECK
Verify your insurance coverage.
4
IN PERSON MEET & GREET
In person meet and greet to discuss your family's goals.
5
CONSENT FORMS AND PAPERWORK.
Acquire necessary consent and sign paperwork.
6
AUTISM ASSESSMENT
Participate in a personalized assessment with a qualified BCBA.
7
TREATMENT PLAN
BCBA will write a treatment plan and submit to insurance for authorization.
8
START SERVICES
Get started with ABA services in your home or at our center.
Comprehensive Care with Broad Insurance Acceptance
All Insurance Options
We work to credential our BCBAs with as many insurances as possible, making your access to care easier than ever.
- Aetna
- Blue Cross Blue Shield
- ChampVA
- ComPsych
- Molina Healthcare
- MotivHealth
- PEHP Health & Benefits
- Select Health
- United Healthcare
- University of Utah Health
- Anthem (Blue Cross Blue Shield)
- Regence (Blue Cross Blue Shield)
- Cigna
- DMBA
- EMI Health
- Medicaid
Apply for Services
Autism Services/Diagnosis Application
Apply now using our intake form!
Fill out our brief form to apply for autism services or an autism diagnosis. If you have any questions, don't hesitate to call us!
* We currently take most major insurance plans, including Medicaid.