in take Single-disciplinary assessmentMulti -disciplinary assessmentTreat picky eating programA package of treatment sessions in one specialtyIntensive rehabilitation programmeIntensive behavioral programIndividual treatment session Welcome to the Autism Center of Excellence, we look forward to working with you and providing rehabilitation services to your son/daughter Please fill out the form with correct and accurate information to avoid any delay in the process of providing service to your child. Filling out the form may take a quarter of an hour to half an hour. Make sure that all data is completed correctly and sent when you finish filling out the form, and if you exit from the page, you will have to refill the data Triple Beneficiary Name * Beneficiary Name Beneficiary birthdate * Beneficiary birthdate Beneficiary Age Beneficiary Age Gender * Male Female How did you know about the Autism Center of Excellence and its services? * Social mediaFriendFrom Autism Center of Excellence services previous beneficiarya professional working in autism fieldOther If you are human, leave this field blank. Next