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40 Southbridge St., Suite 202
Worcester, MA 01608
508-926-8910
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508-926-8910
info@ftfbc.com
40 Southbridge St., Suite 202
Worcester, MA 01608
Quick Consult
Name
*
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Last
Email
*
I confirm that I am a professional seeking consultative services in relation to the clients in my professional care.
*
BCBA
BCaBA
Pediatrician/Family Physician
Psychologist
Teacher
Paraprofessional
SLP
OT
Direct-care staff
Administrator
Other
I confirm that I have all necessary consents to discuss these matters and have taken all necessary steps to protect personal and confidential information of my clients.
To confirm the above, click here.
I acknowledge that services provided are consultative in nature and may require the involvement of a certified behavior analyst (BCBA) who will be responsible for the implementation and daily supervision of the assessment and treatment procedures, staff training, parent training, and follow-up.
To acknowledge the above, click here.
I assume all responsibility for all aspects of consumer and caregiver care and safety, and program administration with respect to the case(s) discussed during the consultation. Any liability arising from the provision of services and the adoption of any recommendations provided by the consultant will be my sole responsibility.
*
To confirm the above statement, click here.
In order to assist FTF in assigning a consultant with the most relevant expertise, identify all relevant concerns and provide a brief summary of the case(s) that you plan to discuss during the appointment.
*
Practical Functional Assessment and Skill-based Treatment
Sleep
Eating Problems
Severe Problem Behavior
Staff/Parent Training
Classroom management
Balance/prevention programs
Toilet training
Other
Please provide your availability, in hour long increments, for the next 5 days. Please include your time zone.
Please provide a brief summary of the case(s) below:
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Cost of hour consult
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Price:
$300.00
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