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 for Family Member / Friend

This form is to be completed by a parent, other family member or friend of an autistic individual to receive assistance.

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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Call: (216) 464-7600 x200