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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 Adult Seeking a Diagnosis

This form is to be completed by an adult who suspects they are autistic and wants to receive assistance for themselves. If you are a parent or other family member of an autistic individual, please use this form.

DISCLAIMER: Please note that by clicking submit you are agreeing to receive occasional correspondence from Milestones Autism Resources. The personal information collected is only used by Milestones Autism Resources staff. We do not share your information with any third parties. We use your personal information to appropriately process your requests and present you with the information you need, and we may use your demographic information from grant applications.

Si el español es su idioma principal, puede traducir este formulario (y este sitio web) al español haciendo clic en la palabra Español en la esquina superior derecha de la ventana de este sitio web.

AVISO DE RESPONSABILIDAD: Tenga en cuenta que al hacer clic en Enviar, acepta recibir correspondencia ocasional de Milestones Autism Resources. La información personal recopilada solo la utiliza el personal de Milestones Autism Resources. No compartimos su información con terceros. Usamos su información personal para procesar adecuadamente sus solicitudes y presentarle la información que necesita, así como también podríamos usar su información demográfica de las solicitudes de subvenciones.

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Need assistance? Let Milestones be your local guide.

Unsure of where to start? Contact our free Helpdesk with your questions, and we will do the research for you!

Visit milestones.org/helpdesk and complete an intake form.