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.

Please note that by clicking submit you are agreeing to receive occasional correspondence from Milestones Autism Resources. We are currently reviewing our policy and are planning to revise it in the near future.

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.

Tenga en cuenta que al hacer clic en Enviar, acepta recibir correspondencia ocasional de Milestones Autism Resources. Actualmente estamos revisando nuestra política y planeamos revisarla en un futuro próximo.


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Need assistance? Let Milestones be your local guide.

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Visit and complete an intake form.