2022 Milestones National Autism Conference
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Milestones Autism Resources

4853 Galaxy Parkway, Suite A
Warrensville Heights, OH 44128

Phone: (216) 464-7600

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Intake Form - I am an Autistic Individual

This form is to be completed by autistic individuals or individuals who suspect they are on the spectrum in order to receive assistance for themselves. If you are a parent or other family member of an autistic individual, please use this form.

If Spanish is your primary language, you can translate this form (and this website) to Spanish by clicking the word Español in the upper right corner of this website window.

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