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Shandy Clinic

Exceptional Therapy For Exceptional Children

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    • Multidisciplinary Autism Evaluations
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Home » About » New & Existing Patient Forms

New & Existing Patient Forms

For your first visit, please contact us. Afterward, fill out the needed forms below:

Occupational, Speech, and Physical Therapy

  • New Patient Paperwork

Applied Behavior Analysis (ABA)

  • ABA Supplemental Packet

Autism Evaluation (ASD)

  • Shandy Clinic Assessment Team Intake Packet
  • Developmental History
  • Consent & Disclosure

Providers – Referral Sheet

Download our Patient Referral Sheet

Primary Sidebar

Medicaid Mileage Reimbursement Program

Medicaid Program Attendance To Appointments Is Mandatory To Get This Benefit We Will Help You Set It Up
  • If you have access to a car but don’t have the funds to buy gas to get to you child’s appointments, you may qualify for gas mileage reimbursement.
  • You get paid to drive your child to their appointment.
  • No waiting for transportation.
  • Friends, relatives and neighbors can be paid to take your child to their appointments.

Medicaid Mileage Reimbursement Next Steps

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