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Please email admin@squarepegsconnect.com once you complete
INSTRUCTIONS FOR INTAKE/RELEASE FORMS
How to Complete the Application:
Option 1: Online Application
- Click the "Online Intake Application" button above.
Option 2: Download and Complete the Forms
- SPLC-SPBS Intake and Medical-Educational Release.
- Please download and complete these forms using Adobe
Prefer Electronic Submission:
We prefer electronic submission to ensure that the information remains legible and easy to read. If you are unable to fill out the forms using Adobe and need to print them, please ensure they are legible and return them to us in PDF format, not as a picture.
Documents must be returned Attach as PDF:
Save and name the files as follows: {Child's Name} Intake and {Child's Name} Release.
Please attach the completed forms as PDF files.
Do not send pictures or screenshots, as they are often too dark and difficult to read.
Submitting the Forms:
Submitting Your Application:
Once you have completed the online application, please send an email to admin@squarepegsconnect.com, including your child's name in the subject line.
Submitting Downloaded Forms:
After completing the downloaded forms, please email them to admin@squarepegsconnect.com.
Contact Information:
If you have any questions or need assistance with the forms, please reach out to Judith at Square Pegs Admissions by calling 850-270-8411.
Insurance
What Insurance Is Accepted?
We accept Tricare, Blue Cross/Blue Shield, Cigna, and various forms of Medicaid.
Please email us with any additional questions.
Your Insurance will need to cover
Applied Behavior Analysis (ABA) therapy, a widely recognized and evidence-based approach used to improve or change specific behaviors. ABA focuses on understanding how behavior works, how it is affected by the environment, and how learning takes place. It is commonly used to support individuals with Autism Spectrum Disorder (ASD) but can also be applied to a variety of behavioral and developmental challenges.
Key components of ABA services include:
- Assessment and Goal Setting: ABA starts with a detailed assessment of the individual's behavior to identify areas for improvement. Based on this, specific and measurable goals are set, such as improving communication skills, social interactions, or reducing challenging behaviors.
- Behavioral Interventions: Using positive reinforcement and other evidence-based strategies, ABA therapists help individuals learn new skills, increase desirable behaviors, and decrease problematic ones. Techniques often involve breaking down tasks into small, manageable steps.
- Data Collection and Analysis: ABA relies on the continuous collection of data to monitor progress. This data is used to adjust interventions and strategies in real time, ensuring the therapy remains effective and tailored to the individual’s needs.
- Generalization and Maintenance: ABA aims to help individuals apply learned behaviors and skills across different settings and over time, ensuring that positive changes last and can be maintained independently.
ABA services are typically provided by trained professionals such as Board Certified Behavior Analysts (BCBAs) or Registered Behavior Technicians (RBTs) and may take place in various settings, including schools, clinics, homes, or community environments.
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