Refer A Patient

Refer a child to a team that treats families like their own.

Pediatricians, physicians, and care coordinators —and parents directly — can start an in‑home ABAreferral right here. Once we receive it, our intaketeam reaches out within one business day to verifybenefits and schedule a consultation.

Join the ABA Dream Team – Where Passion Meets Purpose!

Start a referral

Takes about two minutes. Choose the option that fits you.

This is a secure referral form. The details you share are treated as protected health information (PHI) and used only to coordinate care, verify benefits, and contact you.

About you & your practice

Contact name *

Practice / organization *

Work email *Enter a valid email.

Phone *

Practice addressOptional — helps us coordinate records.

About you

Your name *Required.

Your email address *Enter a valid email.

Your phone number *Required.

State *Required.

Your ZIP code *Required.

Your child

Child's full name *Required.

Child's date of birth *Required.

InsuranceOptional — we verify coverage for you.

Reason for referralOptional.

Patient information

Patient / child full name *

Child's age

State *

InsuranceOptional — we verify coverage for you.

Reason for referral

Tell us a little more *Please share only the information needed to begin intake.

Encrypted and confidential — reviewed within one business day.

Thank you! Your submission has been received!

Oops! Something went wrong while submitting the form.

WE'RE JUST A MESSAGE AWAY

Our team is ready to help

Have a question before you refer, or need to send records? Reach the intake team directly.

Referral & intake

Send questions or records andwe'll route them to the right BCBA.

info@myteamaba.com

Prefer to call?

Talk a referral through with our intake team, Monday–Friday.

1-855-5MY-TEAM

Visit or mail us

822 Montgomery Ave, Suite 304

Narberth, PA 19072